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How Transformational Leadership Can Inspire Others

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

essay topics on transformational leadership

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

essay topics on transformational leadership

  • Key Components
  • Transformational Traits
  • Transformational vs. Transactional
  • Potential Pitfalls

Transformational leadership is a  leadership style that can inspire positive changes in those who follow. Transformational leaders are generally energetic, enthusiastic, and passionate. Not only are these leaders concerned and involved in the process, but they are also focused on helping every member of the group succeed.

Transformational leaders take control of situations by conveying a clear vision of the group's goals. These leaders have a marked passion for the work and an ability to make the rest of the group feel recharged and energized.

Transformational leaders focus on helping members of the group support one another and provide them with the support, guidance, and inspiration they need to work hard, perform well, and stay loyal to the group. The primary goals of transformational leadership are to inspire growth, promote loyalty, and instill confidence in group members.

This article discusses the characteristics of transformational leadership and its effects on groups.

History of Transformational Leadership

The concept of transformational leadership was initially introduced by leadership expert and presidential biographer James MacGregor Burns. According to Burns, transformational leadership can be seen when "leaders and followers make each other advance to a higher level of moral and motivation."

Through the strength of their vision and personality, transformational leaders are able to inspire followers to change expectations, perceptions, and motivations to work towards common goals.

Later, researcher Bernard M. Bass expanded upon Burns's original ideas to develop what is today referred to as Bass’s Transformational Leadership Theory. According to Bass, transformational leadership can be defined based on the impact that it has on followers. Transformational leaders, Bass suggested, garner trust, respect, and admiration from their followers.

Mental Health in the Workplace Webinar

On May 19, 2022, Verywell Mind hosted a virtual Mental Health in the Workplace webinar, hosted by Amy Morin, LCSW. If you missed it, check out  this recap  to learn ways to foster supportive work environments and helpful strategies to improve your well-being on the job.

Components of Transformational Leadership

Bass also suggested that there were four different components of transformational leadership. The four main elements of transformational leadership are:

  • Intellectual stimulation: Transformational leaders not only challenge the status quo; they also encourage creativity among followers. The leader encourages followers to explore new ways of doing things and new opportunities to learn.
  • Individualized consideration: Transformational leadership also involves supporting and encouraging individual followers. To foster supportive relationships, transformational leaders keep lines of communication open so that followers feel free to share ideas and so that leaders can offer immediate recognition of the unique contributions of each follower.
  • Inspirational motivation: Transformational leaders have a clear vision that they can articulate to followers. These leaders can also help followers experience the same passion and motivation to fulfill these goals.
  • Idealized influence: The transformational leader serves as a role model for followers. Because followers trust and respect the leader, they emulate this individual and internalize their ideals.

Groups led by this type of leader tend to be both successful and loyal. They give a lot to the team and care deeply about the group's ability to accomplish its goals. Turnover tends to be relatively low as transformational leaders can inspire a great deal of commitment in their followers.

Transformational Leadership Traits

So what are some typical signs of a transformational leader? Common characteristics of transformational leaders include:

  • Able to encourage others to communicate and participate
  • Active listening skills
  • Adaptability
  • Authenticity and genuineness
  • Emotionally intelligent
  • Inspirational
  • Open-mindedness
  • Proactive problem-solvers
  • Self-awareness
  • Willingness to take responsibility
  • Willingness to take well-informed risks

While each leader is different, transformational leadership is characterized by a number of key traits. Five of the main qualities of a transformational leader are authenticity, self-awareness, humility, collaboration, and interdependence.

Examples of Transformational Leadership

Recognizable figures who are often cited as examples of transformational leadership include:

  • Barack Obama : The former U.S. President was known for his transformational approach to running his administration, as well as his unifying, motivating, and hopeful communication style.
  • Nelson Mandela : The former President of South Africa was famous for serving as a source of authentic inspiration.
  • Oprah Winfrey : The media mogul is famous for her charismatic, visionary, and inspirational leadership style.
  • Steve Jobs : Jobs was famous for his visionary leadership that transformed Apple into a leader in the technology industry.

Effects of Transformational Leadership

In their classic text, Transformational Leadership , authors Bass and Riggio explained that these leaders inspire people to achieve extraordinary results. Group members are not just encouraged to participate; they are also inspired to become leaders themselves.

Transformational leaders can accomplish this by being responsive and empowering. The individual's goals become better aligned with the purposes of the entire group so that each group member's success furthers the organization's goals.

Researchers have found that this style of leadership can have a positive effect on the group. Some of these effects include:

  • Better performance : Those led by transformational individuals have better performance and are more satisfied than those in groups with different types of leaders.
  • Better well-being : Employees who identified a higher level of transformational leadership in their employers also reported higher levels of well-being. The effect stayed significant even after researchers controlled for factors linked to well-being, such as job strain, education, and age.
  • Sense of empowerment : This is attributed to the fact that transformational leaders believe that their followers can do their best, leading group members to feel inspired and empowered.

How to Become a More Transformational Leader

Becoming a more transformational leader may provide many benefits. Researchers believe that such results can help companies develop leadership training programs that can be used to teach transformational leadership skills.

Acquiring communication skills such as resolving workplace conflicts and recognizing employees' needs are important parts of transformational leadership. Such programs can serve as essential parts of health promotion efforts in the workplace to help improve employee well-being.

What can you do to become a more transformational leader? Leadership experts suggest that a robust and positive future vision plays a critical role. Not only is it essential to believe in this vision yourself, but you've also got to inspire others to buy into your vision as well.

You can also develop your transformational skills by being:

  • Trustworthy

Transformational Leadership vs. Transactional Leadership

Transformational leadership is often contrasted with transactional leadership , which is a style that is essentially the opposite of transformational. In the transactional approach, leaders motivate their subordinates through the use of rewards and punishment.

While the transformational approach focuses on communication, inspiration, and positive reinforcement, transactional leaders supervise, monitor performance, and create routines to maximize efficiency. While the transactional approach can be effective in some situations, it does not foster loyalty, innovation, or creativity.

Motivates using rewards and punishments

Focused on compliance

Tends to focus on short-term goals

Uses extrinsic rewards (pay, promotions, etc.)

Motivates using enthusiasm and charismatic inspiration

Focused on commitment

More focused on long-term success

Uses intrinsic rewards (esteem, pride, etc.)

Potential Pitfalls of Transformational Leadership

While transformational leadership is often viewed as one of the best approaches to leadership, that doesn't mean that it is necessarily right for every situation. For example, when group members need more guidance and direction, it can be more effective to utilize a more transactional approach.

The transactional style can help improve group cohesion and commitment, but it can also contribute to burnout when group members feel constantly pressured to give up all of their time and effort to support the goals of the group.

In situations where a lot of creativity and innovation are important to success, a transformational style is often a beneficial approach. But if the focus is on achieving a prescribed set of short-term goals, taking a more transactional approach might lead to less chaos and better results.

A Word From Verywell

The transformational style of leadership can be highly effective when used appropriately, but it might not necessarily be the best choice for every situation. In some cases, groups may require a more managerial or autocratic style that involves closer control and greater direction, particularly in situations where group member are unskilled and need a lot of oversight.

One way to improve your own leadership skills is to assess your own current leadership style and think about ways in which your strengths can benefit the group you are leading. By evaluating your own skills, you will be better able to play to your strengths and work on improving your areas of weakness.

Allen GP, Moore WM, Moser LR, Neill KK, Sambamoorthi U, Bell HS. The role of servant leadership and transformational leadership in academic pharmacy .  Am J Pharm Educ . 2016;80(7):113. doi:10.5688/ajpe807113

Choi SL, Goh CF, Adam MB, Tan OK. Transformational leadership, empowerment, and job satisfaction: the mediating role of employee empowerment .  Hum Resour Health . 2016;14(1):73. doi:10.1186/s12960-016-0171-2

Psychology Today. Are you a transformational leader ?

Jacobs C; Pfaff H; Lehner B, et al. The influence of transformational leadership on employee well-being: Results rrom a survey of companies in the information and communication technology sector in Germany. J Occup Environ Med . 2013;55(7):772-8.​ doi:10.1097/JOM.0b013e3182972ee5

Bass, B. M. & Riggio, R. E. Transformational Leadership . Mahwah, New Jersey: Lawrence Erlbaum Associates, Inc; 2008.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

45+ Transformational Leaders (Examples + Quiz)

practical psychology logo

Have you ever wondered what makes someone a great leader? Is it the way they talk, the things they do, or the choices they make?

Well, you're in for a treat because today, we're diving deep into the world of leadership. But we're not just talking about any leaders; we're talking about "transformational leaders." These are the superheroes of leadership who change things for the better and inspire everyone around them.

Transformational leaders are like awesome coaches who not only guide their team but also inspire everyone to be better. They bring big changes and make people want to follow them because they have great ideas and a way of making everyone feel important.

In this article, we'll explore leadership and why it's so important. We'll get to know some of the most amazing transformational leaders from history, business, and politics. Want to know if you have what it takes to be a leader? Stick around till the end for a cool quiz!

What is Leadership?

Steve Jobs

Before we jump into the superhero world of transformational leaders, let's figure out what leadership \-

is. Leadership isn't just about being the boss or telling people what to do. It's about guiding a group of people toward a common goal.

Think of it like being the captain of a ship. The captain doesn't just steer; they also ensure everyone on board works together so the ship reaches its destination safely.

John C. Maxwell, a famous leadership expert, once said, "A leader is one who knows the way, goes the way, and shows the way." That sums it up pretty well! A leader doesn't just give orders; they set an example for others to follow.

Leadership is important in all parts of life. Whether on a sports team, in a club, or even in a group project at school, good leadership can make the difference between winning and losing, success and failure.

The great American statesman Benjamin Franklin said this: "Well done is better than well said." In other words, a true leader shows their worth through actions, not just words.

The Concept of Transformational Leadership

So you've got a grip on what general leadership is, right? Great! Now, let's delve into the amazing realm of transformational leadership. These aren't just any leaders; these are the superheroes of the leadership world.

What is a Transformational Leader?

First off, what exactly is a transformational leader? Imagine a coach who not only trains you but also makes you want to be the very best version of yourself. That's a transformational leader for you!

Transformational leaders not only bring about significant changes but also have this magnetic quality that makes people want to follow them. They possess unique traits that separate them from other types of leaders.

Key Characteristics

So what makes them so special? Let's break it down:

  • Visionary: Transformational leaders have something called 'vision.' They can look into the future and see what could be rather than what is. It's like having a magical map that outlines the steps to a better world. This vision isn't just for them; they share something to inspire everyone else.
  • Inspirational: Have you ever listened to someone speak and felt chills? Transformational leaders have the power to inspire. They use their words and actions to motivate others. It's not just about talking; it's about making you feel you can achieve the impossible.
  • Empathetic: Empathy is about understanding and sharing the feelings of others. Transformational leaders have loads of it. They can put themselves in your shoes, making you feel seen and understood. This builds trust, a crucial ingredient in any leader-follower relationship.
  • Accountable: Taking responsibility is a big deal. If something goes well, a transformational leader will credit the team. If something goes wrong, they'll step up and take responsibility. No blame games here!
  • Adaptive: The world is always changing, and so are the challenges we face. Transformational leaders are quick to adapt. They're flexible in their approaches and are willing to switch things up if something isn't working.
  • Encourages Creativity: They're not about keeping things the same old, same old. They encourage new ideas and creativity, making everyone feel they can contribute to the big picture.

Why are Transformational Leaders Important?

In today's world, everything is shifting quickly—technology, social issues, even the climate. To keep up with these rapid changes and to make the world a better place, we need leaders who are not just managers but visionaries. They can inspire collective action for positive change.

Imagine someone rallying people to fight against climate change or championing social justice. That's what a transformational leader does. They don't just respond to change; they drive it.

From Theory to Practice

Transformational leadership isn't new; it was introduced by James MacGregor Burns in 1978. Since then, it's been a hot topic in psychology and business. Researchers and experts have found that transformational leaders can significantly improve team morale, increase productivity, and even boost the well-being of entire communities.

So there you have it—the ins and outs of transformational leadership. They're the captains who not only steer the ship but make sure every single crew member is empowered to be their best self. Whether in politics, business, or social change, transformational leaders are the ones who bring dreams to life.

Business Examples

Indra nooyi.

As the former CEO of PepsiCo, Indra Nooyi was one of the most powerful women in business. She was known for steering the company towards both profitability and sustainability. Her focus on making PepsiCo a greener and more socially responsible organization sets her apart as a transformational leader.

The founder of Amazon, Jeff Bezos, turned the way we shop on its head. Starting with an online bookstore, Bezos expanded Amazon into a retail giant that sells everything from groceries to electronics. His customer-centric philosophy and willingness to take risks make him a transformational leader.

Bill and Melinda Gates

Bill Gates is the guy who co-founded Microsoft, the company that gave us Windows and Office. Melinda Gates, his then-wife, has been a powerful force in business and philanthropy too. Together, they started the Bill & Melinda Gates Foundation . They didn't just sit back and enjoy their money; they decided to use it to solve some of the world's biggest problems. We're talking about things like poverty, hunger, and disease. From providing vaccines to kids in poor countries to improving education in the United States, they've been game-changers. They show that leadership is not just about making money; it's about making a difference.

Oprah Winfrey

Oprah rose from poverty and hardship to become one of the most influential media proprietors and philanthropists in the world. She broke numerous barriers and transformed daytime television with her focus on self-improvement, spirituality, and philanthropy. She also started a book club to inspire millions to read more.

Political Examples

Franklin d. roosevelt.

Serving as the President of the United States during the Great Depression and World War II, FDR implemented the New Deal , a series of programs, public work projects, financial reforms, and regulations to bring about relief and reform: his Fireside Chats , a series of radio broadcasts, shaped public opinion and policy.

Angela Merkel

The first female Chancellor of Germany, Angela Merkel, has been recognized for her leadership within the EU and globally. Known for her pragmatic approach to solving crises, Merkel has tackled everything from the financial crisis to the issue of refugees with a sense of calm and reasoned decision-making.

Barack Obama

The 44th President of the United States, Barack Obama, broke barriers as the first African American to hold the office. His policies on healthcare and international relations, as well as his inspirational speaking style, make him a transformational leader.

Aung San Suu Kyi

Initially a symbol of peaceful resistance against military rule in Myanmar, Aung San Suu Kyi received the Nobel Peace Prize in 1991. Although her subsequent political actions have complicated her reputation, her initial impact as a transformational leader advocating for democracy and human rights was globally recognized.

Activist Examples

Malala yousafzai.

Imagine being a teenager and standing up for girls' education in a place where that idea is not popular. Malala Yousafzai, from Pakistan, did just that. Even after being attacked for her beliefs, she didn't stop. She went on to become the youngest-ever Nobel Prize winner. Her brave actions and words have inspired young people worldwide to stand up for what is right.

Susan B. Anthony

Susan B. Anthony was a key player in the women's suffrage movement in the United States. She worked tirelessly to get women the right to vote. Her leadership skills and vision were so impactful that she even got a coin with her face . Susan didn't live to see women get the vote, but her efforts set the stage for this big change.

Martin Luther King Jr.

Martin Luther King Jr. was a civil rights leader who fought against racial segregation in America during the 1950s and 1960s. His famous "I Have a Dream" speech inspired millions to seek equality and justice. He was a master orator who could move crowds, and his nonviolent methods became a template for other civil rights movements worldwide.

Nelson Mandela

Imprisoned for 27 years for fighting against apartheid in South Africa, Nelson Mandela emerged not with vengeance but with a vision of peace and unity. His leadership led to the dismantling of institutionalized racial segregation and earned him a Nobel Peace Prize.

Mahatma Gandhi

Known for his role in India's independence from British rule, Mahatma Gandhi was a pioneer of nonviolent civil disobedience. His ability to unite people across religious and ethnic lines for a common cause made him a transformational leader.

Harriet Tubman

Harriet Tubman was an American abolitionist who led hundreds of enslaved people to freedom via the Underground Railroad. Despite the tremendous personal risk, her conviction and bravery changed the course of history.

Cesar Chavez

Cesar Chavez was a champion for farmworkers. Back then, farmworkers in the United States had terrible working conditions and barely any rights. Chavez decided to change that. He organized strikes and boycotts, and guess what? It worked. New laws were made to protect the workers, all thanks to Chavez's leadership and courage to stand up for the less fortunate.

Gloria Steinem

Gloria Steinem is one of the most famous feminists, and she's been fighting for women's rights for decades. She co-founded "Ms." magazine , which was all about women's issues at a time when most magazines were focused on home and beauty for women. Steinem fought for things like equal pay and the right for women to make choices about their bodies. She's a living example of how one person's voice can start a movement.

Science and Tech Examples

Marie curie.

Marie Curie

Marie Curie was the first woman to win a Nobel Prize, and she didn't stop at one; she won two! She made groundbreaking discoveries in the field of radioactivity . This was at a time when women in science were super rare. Her work wasn't just smart; it was revolutionary, and it opened doors for women in science.

Elon Musk is like the real-life Iron Man. He's got his hands on electric cars, space travel, and underground tunnels. His companies, like Tesla and SpaceX, are all about making the future look cool. He's not just a boss running a company; he's a visionary leading us into what could be the future.

Imagine a world without smartphones, without easy-to-use computers, or without animated movies like "Finding Nemo." Hard to picture, right? Steve Jobs, the co-founder of Apple, made all these things possible. When most people were happy with regular cell phones, he dreamed of something better—a phone that could play music, browse the internet, and take photos. That's how the iPhone was born. Jobs was a leader who didn't just follow the trends; he set them. His ideas and products have changed our lives, work, and play.

Alan Turing

Have you ever considered the origins of modern computers? Alan Turing, a British mathematician and computer scientist, is a giant upon whose shoulders we stand. Not only did he play a crucial role in decrypting German codes during World War II, accelerating the Allied victory, but he also pioneered the concepts that form the basis of modern computing. He proposed the Turing Test, a criterion of artificial intelligence that challenges machines to mimic human thought—a concept that continues to influence the evolving landscape of AI. Turing’s genius altered history and the trajectory of technology, though his true acclaim came posthumously.

Rosalind Franklin

You've probably heard of DNA, which makes you who you are. Rosalind Franklin was a chemist who helped discover the structure of DNA. She used X-ray crystallography to take super-detailed pictures of DNA strands. Even though she didn't get a Nobel Prize like some of her colleagues, her work was crucial for understanding how life works at the molecular level.

Katherine Johnson

Katherine Johnson was a math wizard who worked for NASA during the early years of the U.S. space program. She was among the first African-American women to work as a NASA scientist. Johnson calculated the trajectories for many space missions, including the Apollo 11 mission to the Moon. Her story shows that intelligence and leadership don't depend on gender or skin color.

Tim Berners-Lee

Imagine a day without using the internet. Hard, right? You can thank Tim Berners-Lee for that. He's the guy who invented the World Wide Web. And guess what? He made it open and free for everyone to use. Berners-Lee didn't just create a technology; he created a whole new way for people to share information, connect, and even change the world.

Arts and Culture Examples

William shakespeare.

You've probably heard the phrase, "To be or not to be." Well, that came from William Shakespeare, an English playwright who lived over 400 years ago. His plays are still performed today because they dive deep into what it means to be human. Shakespeare had this amazing ability to capture the highs and lows of life in his work, inspiring countless other writers and thinkers.

Frida Kahlo

Frida Kahlo was a Mexican artist who wasn't afraid to show raw emotion and pain in her paintings. She used her art to discuss topics people often kept quiet, like suffering and love. Despite facing many personal challenges, including health problems, Frida's artwork and vision have made her an icon in art and feminist circles.

George Orwell

You might know George Orwell for his books like "1984" and "Animal Farm." These books aren't just stories; they warn about what can happen when power is abused. Orwell's writing has sparked many conversations about freedom and government control.

Christiane Amanpour

Christiane Amanpour is one of the world's leading news reporters. She has reported from war zones and interviewed many powerful people. Amanpour is known for asking tough questions and bringing important issues to light. She's a role model for journalists everywhere.

Sports Examples

Michael jordan.

When you think of basketball, you probably think of Michael Jordan. His talent was incredible, but what made him a transformational leader was his ability to make his entire team better. Jordan wasn't just about scoring points; he was about winning as a team. His work ethic and competitive spirit have inspired countless athletes.

Serena Williams

Serena Williams has smashed records in the world of tennis, but she's also been a strong voice off the court. She speaks out on issues like racial equality and women's rights. Serena is a role model for young athletes, showing that you can be both a great player and a great person.

Education Examples

Maria montessori.

Maria Montessori was an Italian doctor who became an educator because she believed kids could learn better. She thought classrooms should feel like home and that kids should have the freedom to choose what they learn. Schools worldwide now use the Montessori method , showing how impactful her ideas have been.

Jaime Escalante

Jaime Escalante was a math teacher in East Los Angeles who proved that students in struggling schools could excel in subjects like calculus. His story was so inspiring that they even made a movie called "Stand and Deliver." Escalante showed that with high expectations and dedication, all students can succeed.

John Dewey was an American philosopher and educator who changed our thinking about teaching and learning. Dewey believed schools shouldn't just dump facts into kids' heads but should help them think critically and solve problems. He introduced the idea of "learning by doing," which means students learn best when they're active, not just sitting and listening. His ideas still influence how we teach today.

Sal Khan started by tutoring his cousin in math over the internet. Now, his website, Khan Academy , teaches millions of students worldwide in all subjects for free! Khan flipped the script on traditional education by using technology to make learning accessible to anyone, anywhere. His work shows the power of innovation in education.

Ken Robinson

Sir Ken Robinson was an education expert who believed schools needed to focus more on creativity. He gave one of the most-watched TED Talks ever , arguing that traditional education kills creativity. Robinson pushed for a broader view of intelligence that includes artistic and emotional smarts, not just book smarts.

Environment Examples

forest landscape

Rachel Carson

Rachel Carson was a scientist and writer whose book, "Silent Spring," got people talking about taking care of the Earth. Before her book, not many people paid attention to how chemicals like pesticides could harm nature. Carson sparked a movement that led to the creation of the U.S. Environmental Protection Agency .

Greta Thunberg

Greta Thunberg is a young climate activist from Sweden who gained worldwide attention for her straightforward and blunt speeches about climate change. Starting with a one-person "School Strike for Climate," Greta's actions have inspired millions of young people to protest for a better future. Even world leaders listen when she talks.

Jane Goodall

Jane Goodall is like the queen of the jungle, but for real. She spent years living with chimpanzees in Africa to study their behavior. But she didn't stop there. Goodall used her knowledge to teach people the importance of protecting these animals and their homes. Thanks to her work, we know much more about how similar chimps are to humans and why we must protect our environment.

David Attenborough

If you've ever watched a nature documentary, chances are you've heard David Attenborough's voice. This British broadcaster has been teaching people about the wonders of the natural world for decades. But it's not just about cool videos of animals. Attenborough uses his platform to discuss serious issues like climate change, habitat loss, and extinction. His storytelling makes people care about the Earth.

Wangari Maathai

Wangari Maathai was a powerhouse from Kenya with a simple yet revolutionary idea: plant trees to improve the environment and people's lives. She founded the Green Belt Movement , which didn't just plant trees but also trained women in farming and other skills. Maathai's work improved the environment and lifted people from poverty, making her a legend in sustainable development.

Vandana Shiva

Vandana Shiva is an Indian scholar and environmental activist passionate about protecting nature and people's rights. She fights against big corporations that try to control natural resources like water and seeds. Shiva's work has empowered local communities to protect their land and livelihoods , and she's a big voice in the global conversations about sustainability.

Healthcare Examples

Florence nightingale.

Known as the founder of modern nursing, the statistician Florence Nightingale changed healthcare forever. During the Crimean War, she improved hospital sanitation, drastically reducing deaths. She used data and statistics to prove her point, making her an early advocate of using data in healthcare.

Paul Farmer

Dr. Paul Farmer is known for treating infectious diseases in poor countries. He co-founded Partners In Health , which helps bring quality healthcare to people who wouldn't get it otherwise. His work shows that everyone, no matter where they're from, deserves good healthcare.

Imagine a world where kids couldn't play outside because of a scary disease called polio. Jonas Salk changed all that. He's the scientist who developed the first safe and effective polio vaccine. The best part? He didn't try to make money from it. He made it available for everyone, saying the vaccine belonged to the people. Thanks to him, polio is almost wiped out in many parts of the world.

Virginia Apgar

If you're born in a hospital, one of the first tests you'll get is the Apgar Score, named after Dr. Virginia Apgar. She created this quick test to check a newborn's health right after birth. Because of her, doctors can act fast to help babies who need extra care. Apgar's test has saved countless lives and is still used worldwide today.

Gro Harlem Brundtland

Gro Harlem Brundtland is a former Prime Minister of Norway, but she's also a doctor who's done much for public health. She led the World Health Organization and focused on issues like child health and disease control. Brundtland also helped connect the dots between human health and the environment, making people realize that a healthy planet means healthy people.

Psychological Theories of Leadership

road

These theories serve as both a history lesson and a roadmap. They help us understand how our views on leadership have evolved and give us the language and frameworks to discuss and improve our leadership skills.

Trait Theory

The concept of Trait Theory has roots stretching back to ancient times, but its modern form took shape largely through the efforts of psychologists like Gordon Allport in the 1930s and '40s. Allport cataloged what he believed were inherent personality traits — a list of characteristics like "sociable," "reserved," "outgoing," and so on. Regarding leadership, the spotlight often shines on confidence, intelligence, and charisma.

For a long time, the general belief was that leaders were born, not made. This theory was further expanded in the 1940s and '50s when scientists started using assessments and psychological tests to identify leadership traits. However, research from the late 20th century shows that while natural traits can give you a head start, they're not the end-all-be-all. With the right training and experience, people can develop these traits and become effective leaders. So, don't count yourself out if you're not born with what people traditionally consider "leadership traits."

Lewin's Change Theory and Leadership

Kurt Lewin, a German-American psychologist, developed his Change Theory in the mid-20th century, around the late 1940s. Lewin was deeply interested in the human aspects of change and how leadership could facilitate or hinder it. His theory is often summarized with three main stages: Unfreezing, Changing, and Refreezing. Let's dive into these stages and see how they relate to leadership.

The first stage, Unfreezing, involves preparing an organization, or a team, to accept that change is necessary. This is where leadership plays a critical role. Leaders must first understand what needs to be changed and why. They then have the task of communicating this to their team in a way that opens minds to the idea of doing things differently. It's about shaking up the status quo, or the usual way of doing things, to make people receptive to new ideas. A good leader in this phase is an excellent communicator who can navigate resistance and fears that often accompany change.

The Changing stage is where the actual transition happens. Here, leaders must be incredibly skillful in various areas, from problem-solving and decision-making to emotional intelligence. Not only do they need to guide the practical aspects of the change, but they also have to manage the emotional and psychological dimensions. This is where the leader serves as a coach, supporting team members as they try out new roles, learn new skills, and adapt to new situations. It's a delicate balance, as leaders need to push for change without pushing so hard that they lose the support of their team.

Once the change is implemented, the Refreezing stage aims to stabilize the organization in its new state. Leaders during this phase work on reinforcing the changes, making sure they stick and become part of the new normal. This often involves additional training, setting up new policies, or even celebrating the successful implementation of the change to boost morale. In this stage, the leader is an anchor, providing stability and direction as the team adjusts to the new environment.

Lewin's Change Theory has had a significant impact on how organizations approach change management and leadership. It's not just a roadmap for change; it also outlines the roles a leader must play at each stage of the process. This multi-faceted approach to leadership underscores the complexity and adaptability required to guide a team through periods of change effectively.

Behavioral Theory

Fast-forward to the 1950s and 1960s, when psychologists at Ohio State University and the University of Michigan, including the renowned Rensis Likert, began to redefine leadership through the Behavioral Theory . Likert, known for developing the Likert scale—a methodological tool that gauges attitudes by asking respondents to rate statements on a multi-point scale—is also credited for identifying various behaviors influencing team dynamics, such as decision-making processes, goal setting, and fostering team spirit.

Their research suggested that adaptable leaders who tailored their behavior to their team's needs often achieved superior outcomes. For instance, some scenarios may necessitate a leader's direct involvement to mentor and guide. In contrast, others might call for a more hands-off approach, empowering team members to take the initiative. This shift towards Behavioral Theory underscored the notion that effective leadership is not solely innate but can be developed, honed, and taught.

Situational Leadership

Situational Leadership was introduced in the late 1960s and gained popularity in the early '70s. Developed by Paul Hersey and Ken Blanchard, this theory considers the maturity and competence of the leader's followers. These psychologists suggested that effective leadership is not one-size-fits-all but should be adapted based on the situation.

For example, a less experienced team might need a leader who provides clear instructions and monitors progress closely. A more skilled team might thrive under a leader who delegates tasks and encourages independent decision-making. Hersey and Blanchard's theory was revolutionary because it emphasized the dynamic nature of leadership, highlighting the need for leaders to be flexible and adaptable.

Transformational Leadership

In the 1980s, James MacGregor Burns brought the concept of Transformational Leadership into the spotlight. Burns argued that the most impactful leaders go beyond mere transactional exchanges with their followers. Instead, they inspire, energize, and intellectually stimulate their teams.

Leaders who fit this mold—Nelson Mandela, Martin Luther King Jr., or Steve Jobs—don't just set targets and KPIs (Key Performance Indicators). They create a compelling future vision and make their team want to achieve more than they ever thought possible. In essence, they transform not just organizations but also the individuals within them. Transformational leadership is often seen as the highest level of leadership, where the focus is not just on what can be achieved but also on how everyone can develop and grow along the journey.

Personality Types in Leadership

Personality often serves as the building blocks of leadership. How you think, feel, and act naturally affects how you lead. Different models have been developed to understand personality types, but let's focus on two well-known frameworks: the Myers-Briggs Type Indicator (MBTI) and the Big Five Personality Traits.

Myers-Briggs Type Indicator (MBTI)

Developed by Katharine Cook Briggs and her daughter Isabel Briggs Myers in the early to mid-20th century, MBTI classifies people into one of 16 personality types based on four dichotomies: Extraversion/Introversion, Sensing/Intuition, Thinking/Feeling, and Judging/Perceiving. Leaders can fall into any of these 16 categories, each with strengths and challenges.

For example, an ENTJ (Extraversion, Intuition, Thinking, Judging) is often seen as a natural leader. They are decisive, strategic, and love challenges. On the flip side, an ISFJ (Introversion, Sensing, Feeling, Judging) leader might excel in creating a harmonious and organized work environment but might struggle with quick decision-making under pressure. Knowing your MBTI type can offer insights into your leadership style and help you identify areas for growth.

Big Five Personality Traits

This is a more modern approach and is widely used in psychology today. It describes personalities based on five broad factors : Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism, often remembered by the acronym OCEAN.

Leaders who score high in Openness are often good at thinking outside the box and are open to new experiences. They can be great at leading teams through change or innovation. Conscientious leaders are reliable and organized, excellent for administrative roles where detail and planning are key.

Extraverted leaders are often great motivators and excel in roles that require a lot of social interaction. Agreeable leaders tend to be good mediators and team players, excellent at fostering a collaborative environment.

Finally, leaders who score low on Neuroticism usually handle stress well and are emotionally stable, which can be crucial in high-pressure leadership roles.

Understanding your personality type is like having a roadmap for your leadership journey. It can help you identify what you're naturally good at, where you might need extra work, and even what types of leadership roles or environments could be the best fit for you. So, whether you're an ENTJ who loves to take charge or an ISFP who leads with empathy and understanding, there's a leadership style that fits you.

Quiz: Do You Have What It Takes to Be a Leader?

Feel free to take this quiz and reflect on your answers. It's just a starting point, but it might give you insights into your leadership style and potential. And if you decide you might not be fit for a leader, there are many other things you might be talented at !

Instructions: Read each question carefully and choose the answer most closely matches your thoughts or behaviors. There are no right or wrong answers—just be honest with yourself!

1) When in a group project, do you prefer to:

A) Take charge and set goals B) Assist whoever is in charge C) Wait to be told what to do D) Work independently, and let others do their thing

2) How do you handle stress?

A) Well, I stay focused and make decisions B) Okay, but I prefer someone else to take the lead C) Not great, I tend to avoid stress D) I'm indifferent, stress doesn't affect me much

3) Do you like trying new things?

A) Yes, I love new challenges and experiences B) Sometimes, it depends on the situation C) No, I like sticking to what I know D) Only if I have to, I don't like change

4) How do you handle conflict in a group?

A) I try to resolve it and find a compromise B) I support the peacemaker but don't lead the revolution C) I avoid getting involved D) Conflict doesn't bother me; it's part of life

5) Do you enjoy motivating others?

A) Yes, I find it rewarding B) I can, but it's not my favorite thing C) No, I'd rather focus on my tasks D) Motivating others is not my responsibility

6) Do you like making plans and setting goals?

A) Absolutely, it's essential for success B) It's useful, but not something I love C) I'm not a planner; I go with the flow D) Plans and goals are limiting

7) How do you feel about responsibility?

A) I welcome it; it's an opportunity to grow B) It's fine as long as it's shared C) I'd rather not have too much of it D) Responsibility is overrated

8) How well do you communicate with others?

A) Very well, it's one of my strengths B) Decently, but I'm better at listening C) Not great, I'm more of an introvert D) I communicate only when necessary

9) Do you think leaders are born or made?

A) Made, anyone can learn to lead B) Both some traits help, but skills can be developed C) Born, it's a natural gift D) Neither leadership is about skills or traits

10) What motivates you the most?

A) Achieving goals and making a difference B) Helping others succeed C) Personal gain and benefits D) Freedom and independence

  • Mostly A's: You have strong leadership potential! You're confident, like challenges, and enjoy helping others.
  • Mostly B's: You're a team player who can lead when needed but is comfortable supporting others.
  • Mostly C's: Leadership might not be your natural inclination, but that doesn't mean you can't contribute to a team.
  • Mostly D's: You value independence and autonomy. You might be more suited for roles that allow you much freedom.

Leadership is an amazing blend of skills, personality, and the ability to inspire others. We've explored various facets of leadership, from transformational leaders who leave lasting impacts on their teams to the psychological theories that help us understand what makes a leader effective. We also delved into how your personality type can shape your leadership style.

Being a leader isn't just about holding a title; it's about how you influence and guide others. Whether you're a business guru like Steve Jobs, a social justice champion like Martin Luther King Jr., an environmental pioneer like Greta Thunberg, or a trailblazer in education like Malala Yousafzai, leaders come in all shapes and sizes.

If you're wondering whether you have what it takes to be a leader, remember that leadership can be cultivated. Sure, some people might be naturally inclined to lead, but many essential leadership skills can be learned and developed over time. Don't underestimate the value of self-awareness: Knowing your strengths and areas for growth is a critical first step in becoming the leader you aspire to be.

We hope this article has given you some insights and tools better to understand the complex and rewarding world of leadership. So, what's stopping you? Go out there, lead with your unique style, and make a difference!

Related posts:

  • What is Transformational Leadership? (Examples + How-To)
  • Kurt Lewin Biography - Contributions To Psychology
  • Kotter's 8 Step Change Model (History + Methods)
  • Lewin’s Change Theory (Definition + Examples)
  • 121+ Strengths Examples for Job Interviews

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159 Leadership Essay Topics & Ideas

18 January 2024

last updated

Leadership essay topics cover a broad range of themes, exploring the various dimensions of leadership. They prompt critical thinking about the attributes, styles, and impacts of effective leaders. Some topics may range from analyzing historical figures’ leadership styles and discussing the role of ethical leadership in contemporary society to exploring transformational leadership in the corporate world. Other themes may consider the impact of leadership in crisis situations or the intricacies of team leadership in sports. Some ideas may include the evolution of leadership theories and how they have shaped modern practices. Additionally, one may discuss the gender dynamics in leadership or the role of emotional intelligence in effective leadership. As a result, leadership essay topics provide a good platform to examine leadership in all its complexity, fostering a comprehensive understanding of what it means to lead, the challenges faced, and the potential impacts that leaders have on their followers and broader society.

Top Leadership Essay Topics

  • Examining Leadership Styles in Diverse Cultural Contexts
  • Transformational Leadership: A Key to Organizational Change
  • Charismatic Leadership and Its Influence on Team Dynamics
  • Ethical Boundaries in Leadership: A Closer Look
  • Women in Leadership: Challenges and Opportunities
  • Servant Leadership: An Approach to Employee Empowerment
  • Crisis Leadership: Strategies for Navigating Turbulent Times
  • Youth Leadership Development: Importance and Benefits
  • Leadership in Non-Profit Organizations: Distinctive Characteristics
  • Comparative Analysis: Autocratic vs. Democratic Leadership
  • Military Leadership: Unraveling the Principles and Practices
  • Leadership in Healthcare: Patient Safety and Quality Care
  • Cross-Cultural Leadership: Navigating Global Business Environment
  • Political Leadership: Power, Influence, and Policy Change
  • Entrepreneurial Leadership: Steering Startups to Success
  • Leadership in Academia: Nurturing Future Innovators
  • Environmental Leadership: Guiding Sustainable Practices
  • Leadership and Emotional Intelligence: The Connection
  • Sports Leadership: Inspiring Team Cohesion and Performance
  • Educational Leadership: Cultivating Excellence in Schools

Easy Leadership Essay Topics

  • Exploring Leadership Traits in Personal Life
  • Understanding Situational Leadership
  • How Do Leaders Influence Team Morale?
  • Appreciating the Value of Leadership in School
  • Leadership in Sports: A Beginner’s Perspective
  • Types of Leadership: A Simple Overview
  • Famous Leaders and Their Leadership Styles
  • Influence of Leadership on Career Success
  • Distinguishing Between Leadership and Management
  • Qualities of Good Leadership: An Exploration
  • Why Is Leadership Important: A Novice’s View
  • Analyzing Leadership in a Favorite Book or Film
  • Leadership Lessons From Famous Historical Figures
  • Personal Leadership Development Plan: A Preliminary Approach
  • Leadership in Volunteering: A Personal Experience
  • Leadership’s Influence on Organizational Culture
  • Effective Communication in Leadership
  • Importance of Leadership in a Successful Business
  • Leadership and Decision-Making Process
  • Youth Leadership: Why It Matters?

Leadership Essay Topics & Ideas

Interesting Leadership Essay Topics

  • Transformational Leadership: An In-Depth Look
  • Unraveling the Mysteries of Charismatic Leadership
  • Unconventional Leadership Styles in Modern Businesses
  • Analyzing Leadership Through Game Theory
  • Leadership Lessons From Unexpected Sources
  • Digging Into the Core of Servant Leadership
  • Neuroscience Behind Effective Leadership
  • Influence of Leadership on Employee Engagement
  • Leadership Styles Around the World
  • Deconstructing Leadership in the Art World
  • AI and Leadership: An Unforeseen Connection
  • Environmental Leadership in the Fight Against Climate Change
  • Leadership Through the Lens of Philosophy
  • Unorthodox Leadership Lessons From Stand-Up Comedy
  • Crisis Leadership: Tackling Difficult Situations
  • Leadership in the Animal Kingdom: Lessons to Learn
  • Exploring Leadership in Extreme Environments
  • Leadership Dynamics in Non-Profit Organizations
  • Analyzing Leadership in Post-Apocalyptic Literature

Leadership Essay Topics

  • Leadership and Vision: Case Study of Elon Musk at SpaceX
  • Jeff Bezos’s Leadership: Shaping Amazon’s Organizational Culture
  • Servant Leadership in Action: Case Study of Tony Hsieh at Zappos
  • Analyzing Leadership Strategies: Mark Zuckerberg at Facebook
  • Richard Branson’s Leadership Style: A Key Factor in Virgin Group’s Success
  • Satya Nadella’s Leadership: Transformation of Microsoft’s Corporate Culture
  • Transformational Leadership: Case Study of Indra Nooyi at PepsiCo
  • Understanding Leadership Through Crisis: Case Study of Mary Barra at General Motors
  • Howard Schultz’s Leadership: Driving Starbucks’ Success
  • Leadership and Vision: Case Study of Larry Page at Google
  • Apple’s Success Under Tim Cook’s Leadership: A Case Analysis
  • Leadership in Crisis: Bob Iger’s Turnaround of Disney
  • Sundar Pichai’s Leadership Style: Google’s Continuous Innovation
  • Leadership and Gender: Case Study of Marillyn Hewson at Lockheed Martin
  • Visionary Leadership: Case Study of Masayoshi Son at SoftBank
  • Leadership Styles in Sports: Case Study of Sir Alex Ferguson at Manchester United
  • Change Management: Case Study of Alan Mulally at Ford Motor Company
  • Transformational Leadership: Case Study of Jack Ma at Alibaba
  • Organizational Turnaround: Leadership Strategies of Lou Gerstner at IBM
  • Sheryl Sandberg’s Leadership Style: Encouraging Diversity at Facebook
  • Decoding the Leadership Style of Tesla’s Elon Musk
  • Innovation and Leadership: Reed Hastings at Netflix
  • Authentic Leadership: Oprah Winfrey’s Influence on the Media Industry
  • The People-First Approach: Case Study of Richard Liu at JD.com
  • Leadership and Business Acumen: Warren Buffet at Berkshire Hathaway
  • Reviving a Brand: Leadership Lessons From Steve Jobs at Apple
  • Leadership and Resilience: Case Study of Brian Chesky at Airbnb
  • Leadership in the Non-Profit Sector: Case Study of Melinda Gates at the Gates Foundation
  • Ethical Leadership: The Case of Howard Schultz at Starbucks
  • The Role of Servant Leadership in Herb Kelleher’s Success at Southwest Airlines
  • Leadership and Change: Case Study of Satya Nadella at Microsoft
  • Leadership Style and Business Success: Case Study of Larry Ellison at Oracle
  • Innovation Leadership: The Case of Susan Wojcicki at YouTube
  • Visionary Leadership: Case Study of Mukesh Ambani at Reliance Industries
  • Analyzing the Leadership Strategies of Andrew Carnegie
  • Jack Welch’s Leadership at General Electric: A Case Study
  • Leadership Lessons From Bill Gates’ Tenure at Microsoft
  • Effective Leadership: Case Study of Ray Kroc at McDonald’s
  • The Impact of Walt Disney’s Leadership on the Disney Corporation
  • Leadership Under Crisis: Case Study of Jamie Dimon at JPMorgan Chase
  • Comparative Analysis of Leadership Practices in Different Civilizations
  • Confluence of Leadership Theories and Quantum Physics
  • Epigenetics: Can Leadership Qualities Be Inherited?
  • Conceptual Intersection of Leadership and Chaos Theory
  • Incorporating Leadership Development Into Higher Education Curriculum
  • Eco-Leadership: Sustainable Management in the Era of Climate Change
  • Analyzing Ancient Tribal Leadership Strategies in Modern Corporate Management
  • Transpersonal Leadership: Merging Psychology, Spirituality, and Business
  • Political Leadership in Post-Truth Era: A Critical Examination
  • Decoding the Complex Relationship Between Leadership and Power Dynamics
  • Investigating the Effect of Leadership Styles on Organizational Resilience
  • Explicating the Role of Ethical Leadership in Corporate Social Responsibility
  • Analyze Leadership Through the Lens of Anthropological Studies
  • The Influence of Military Strategies on Corporate Leadership Practices
  • Exploring Leadership Styles in Multidisciplinary Research Teams
  • Dialectics of Leadership and Followership in Democratic Societies
  • Lattice Leadership: Disrupting Hierarchical Structures in Modern Enterprises
  • Probing the Impact of Transformational Leadership on Innovation Ecosystems
  • An In-Depth Study on Leadership in Virtual and Augmented Reality Environments
  • Deciphering the Paradoxes of Leadership in the Digital Age
  • Transformational Leadership: Unveiling the Effect on Organizational Success
  • Analyzing Autocratic Leadership: Its Potential in Crisis Management
  • Charismatic Leadership: Influence on Employee Motivation
  • Transactional Leadership Versus Transformational Leadership: An Analytical Comparison
  • Laissez-Faire Leadership: How it Shapes Creativity and Innovation in Organizations
  • Exploring Servant Leadership: Understanding Its Influence on Organizational Culture
  • Leadership Styles in Different Cultures: A Comparative Study
  • Women in Leadership: Assessing Progress and Challenges in the 21st Century
  • Leadership During Times of Change: Strategies for Successful Transition
  • Leadership and Emotional Intelligence: Interplay and Influence on Team Performance
  • Ethics in Leadership: Exploring Its Effect on Organizational Trust
  • Leadership Development Programs: Their Efficacy in Shaping Future Leaders
  • Analyzing the Intersection of Leadership and Organizational Strategy
  • Adaptive Leadership in Fast-Paced Industries: Key Strategies and Outcomes
  • Youth Leadership: Exploring Its Significance in Society
  • Leadership in Non-profit Organizations: Challenges and Opportunities
  • Understanding Leadership in Virtual Teams: Key Approaches and Challenges
  • Military Leadership Principles and Their Applicability in Corporate Settings
  • Leadership Communication: Its Effect on Team Dynamics and Cohesion
  • Leadership in Healthcare: Unique Challenges and Strategies
  • Analyzing the Interplay Between Leadership and Employee Engagement
  • Leadership in Academia: A Case Study Approach
  • Leadership Succession Planning: Best Practices and Outcomes
  • Leadership in Startups: Exploring Strategies for Success
  • Leadership and Decision-Making: An Analysis of Approaches
  • Cross-Cultural Leadership: Navigating Global Business Environments
  • Leadership and Organizational Performance: Investigating the Correlation
  • Analyzing Leadership Failures: Lessons for Future Leaders
  • Educational Leadership: Approaches in Modern Pedagogy
  • Leadership in High-Risk Industries: Case Studies in Decision-Making and Safety
  • Analyzing Leadership in the Tech Industry: Case Studies of Successful Leaders
  • Leadership Under Stress: Strategies for Maintaining Composure and Decision-Making
  • Public Sector Leadership: Challenges and Opportunities
  • Leadership and Corporate Social Responsibility: Understanding the Interplay
  • Leadership and Change Resistance: Strategies for Overcoming Employee Pushback
  • Analyzing Leadership Dynamics in Family Businesses
  • Leadership Burnout: Understanding Causes and Prevention Strategies
  • Leadership and Knowledge Management: Unpacking the Connection
  • Leadership Styles in Entrepreneurial Ventures: Investigating Success Factors
  • Analyzing Leadership in Crisis: A Study of Pandemic Responses

To Learn More, Read Relevant Articles

447 position paper topics & essay ideas, 392 entertaining speech topics & ideas.

Transformational Leadership Style: How to Inspire and Motivate

Chioma Ugochukwu

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Chioma Ugochukwu, currently studying Biological Science at Harvard University, serves as the president of the Harvard Foundation for the International Medical Relief of Children.

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People who have transformational leadership possess four attributes to varying degrees (Bass, Avolio, & Atwater, 1996).

They are idealized and charismatic (highly liked role models), demonstrate inspirational motivation (optimistic about goal attainment), are intellectually stimulating (encourage critical thinking and problem-solving), and are considerate (show empathy and purpose).

Transformational Leadership

Transformational leadership inspires positive changes in those led and is invested in the success of every single member involved in the process.

Transformational leaders are full of energy, passion, and drive. It’s not a surprise that these qualities can be the things that can make or break an organization.

This kind of leadership is very popular—it can be seen in board rooms, hospitals, schools, and in the entertainment industry. Suddenly, as we look around, transformation seems to be everywhere.

What most people overlook is the time and effort required to fully understand and apply any leadership style, let alone one as dynamic and powerful as transformational leadership.

Transformational leadership style is characteristic of leaders who focus on supervision and organizational goals achieved through a system of rewards and punishments; maintenance of the organizational status quo.

What is transformational leadership?

  • Transformational leadership is a leadership model that relies on a team’s encouragement to realize overall success. By raising a team’s morale and self-confidence, the team can then align itself to an overall vision or common purpose.
  • This purpose, however, must be established early on for it to be effective. Transformational leadership, when properly applied, can take a struggling or stagnant team, and completely transform it into a productive and dynamic group of individuals.
  • This starts by identifying the struggles and strengths of each individual member. Next, it is up to the leader to define a new common goal and guide the members of the team towards this new vision.
  • Practically, transformational leadership is used to inspire team members to work together as a single unit, rather than many individual parts. For a stat so dynamic, it is no wonder that many researchers and experts had a hand in its development.

In their seminal work, Transformational Leadership , authors Bass and Riggio explained:

Transformational leaders…are those who stimulate and inspire followers to both achieve extraordinary outcomes and, in the process, develop their own leadership capacity. Transformational leaders help followers grow and develop into leaders by responding to individual followers’ needs by empowering them and by aligning the objectives and goals of the individual followers, the leader, the group, and the larger organization.

Origin and Development

Transformational leadership was started by James V. Downton in 1973. He was the first to coin the term. This was later added to by James Burns in 1978.

Burns was a leadership expert and biographer and proposed that it was only through the strength of the vision and personality that team members could be encouraged to follow.

After agreeing to follow, members then are inspired to change their expectations, perceptions, and are invited to a higher level of morality and motivation.

A few years later, Bernard Bass (1990) added even more to the concept. This is known as “Bass’s Transformational Leadership Theory”. Bass added ways to measure and rank the success of transformational leadership as well as the idea of leaders expressing authentic and focused energy to inspire the other team members to become more like them.

Bass felt that measuring the impact inspires more authentic community. He also explained the psychological mechanisms that are the basis of the theory. According to Bass, the followers of a leader must feel not only trust and admiration, but also loyalty and respect.

These emotions create an environment where the followers are willing to work harder than they originally thought they were capable. This is because transformational leaders offer followers something beyond self-gain—an inspirational mission and self-identity.

Even though it dates to the 70’s, Bass’s model looks much more like transformational leadership today. The basis of the transformational leadership style never changes, only the environment in which it must be applied. Therefore, it can apply in every industry, especially team-focused work environments.

Components of Transformational Leadership Style

Bass also suggested that there were four primary elements to transformational leadership style (also known as the “four I”s”): idealized influence, inspirational motivation, intellectual stimulation, and individual consideration.

Each of these four components is valuable to the leadership style and helps to transform its followers into better, more productive people. When these factors are combined, they help transformational leaders radically change the course of their following.

1. Idealized Influence / Charismatic

Idealized influence describes leaders who have charisma, are curious, and deliver messages with simplicity and tact. These leaders are exemplary role models and are readily trusted and respected by all members of the team.

Charisma is one of the essential pieces of this characteristic. Charisma is essential because it is how leaders can rally their followers around a shared vision. Charisma is most often expressed by their ability to listen actively to each team member and focus on the present moment.

Charismatic leaders give praise to individual members of the team with each success, and they are the first to take responsibility when things go wrong. They also provide constructive feedback to each individual team member. Intended influence is also represented through their curiosity.

Curiosity, not intelligence, is the driving force behind the success of these leaders. It is their job to find innovative solutions to problems and create new and dynamic paths for a team to follow.

Displays of charisma make others want to be more like that person, and as a role model, members will strive to mimic this leader.

2. Inspirational Motivation

Inspirational motivation describes leaders that are motivating and willing to commit to a vision. They encourage team members to also commit to this vision by raising team spirit, fostering community and a sense of purpose.

To do this, there must be simplicity in communication. This means their communication style must be best suited to the needs of the team. Leaders speak clearly and concisely to easily articulate their vision to the members.

This provides structure and order so that members can execute tasks without confusion. Leaders articulate a clear plan for the future and communicate expectations in the beginning before the work starts. Leaders must also express their messages with a sense of authority, in order for members to respect their thoughts and trust in their vision.

Along with this, leaders must be upbeat and positive, bringing energy to a room with their enthusiasm. As a visionary, transformational leaders use these skills to look toward future goals and have the foresight to see the small obstacles that may hinder this vision.

They recognize the smallest things that can turn into larger issues. Leaders have intuition towards the things that help to push their team and goals forward. These actions begin to instill trust in their followers and confidence in their leader.

3. Intellectual Stimulation

Intellectual stimulation describes leaders who encourage their members to think outside the box and be innovative. Stimulating followers promote critical thinking and problem-solving skills in order to improve the group or organization as a whole.

This challenges the normal beliefs of a group and encourages the team to perform better than they ever thought originally possible. Encouraging innovation involves each team member in the decision-making process and fosters a sense of importance and a stake in the organization’s over-all success.

The important thing about this is a leader must not criticize the thoughts or opinions of the members. Premature shutting down of ideas can create a climate of distrust and hurt.

Leaders must, therefore gently change the way followers problem-solve and brainstorm new and innovative ways to achieve their teams” goals. In short, leaders must recognize that there are many ways to achieve a goal, and no ordinary path to innovation.

Being a transformational leader requires risk-taking, creativity, curiosity, and openness to new ideas from each individual member.

4. Individual Consideration

Individual consideration is the degree to which a leader attends to each follower’s personal needs. Transformational leadership encourages members by focusing on the way each person effects the overall goal.

This means recognizing and valuing the motivations, desires, and needs of individual members. Upon recognizing the motivation behind the drive of the individual, leaders then provide opportunities for customized training.

This allows team members to grow and learn in an environment they feel comfortable in. Engaging individuals requires emotional intelligence.

Emotional intelligence includes showing genuine compassion, empathizing with the needs of individuals, and encouraging the on-going personal growth of individuals. When a leader takes into account the emotions of their followers, they then learn how to best engage with them.

Emotionally intelligent leaders connect with members, and build a bond based in trust. Leaders act as mentors, or a coach and are willing and open to listening to their followers’ concerns.

Examples of transformational leaders

Transformational leaders are all around us. Because of their marked positive impact on productivity and success, they are at the top of each of their individual industries.

Below are 5 examples of transformational leaders, their stories, and ways that you can begin to apply this leadership style to your own team.

Oprah Winfrey: Media Mogul

Oprah Winfrey was the host and producer of The Oprah Winfrey Show from 1986 to 2011. It is one of the highest rated talk shows in American history, so it is no surprise that Winfrey quickly became one of the richest women in the 20th century.

Winfrey was the continent’s first black multi-billionaire and was among Time Magazine’s most influential people for 6 years straight. Winfrey’s amazing communication skills, beginnings in poverty, and charismatic persona have enabled her to connect with people from every background and inspired people everywhere to dream big.

Amazon boss Jeff Bezos

In 1994, Jeff Bezos took the first step to creating the world’s first online bookstore. Bezos spearheaded the first initiative to create an online eBook reader, where digital eBooks could be stored in an eLibrary for later consumption.

This was introduced as the Kindle. Kindle sales, in addition to multiproduct sales, have contributed to Amazon’s current market value of 1.14 trillion as of April 2020.

Nike Corporation

Nike is one of the most famous footwear companies of the 20th century. With their slogan, “Just Do It,” it is one of the most obvious examples of transformational leadership and motivation.

Nike connected with customers through this focused marketing and created exclusive membership opportunities. By motivating its entire customer base to be the best, most healthy versions of themselves, Nike increased its product development cycle, quickly responding to changes in trends and customer feedback.

This resulted in Nike’s stock price increased from less than $50 to nearly 100 dollars in two years.

Netflix’s Reed Hastings

Reed Hastings founded Netflix in 1997, with a handful of team members. The subscription-based video streaming service offers popular movies and TV shows as well as original content.

When it first launched, despite its large competitor, Blockbuster, Hastings had a grand vision of Netflix replacing this company. He came up with the novel idea of user-friendly streaming that became the starting point of this dream’s actualization. Today, Netflix has nearly 200 million subscribers world-wide and is the largest online streaming service.

Apple’s Steve Jobs

Steve Jobs is one of the best examples of transformational leadership in the 21st century. From wearing pairs of the same clothing each day for increased productivity, to designing the break-through idea of the iCloud, Steve Jobs was the brain behind the success of Apple.

With Steve Jobs’ legacy guiding the company, the company shifted from product-based identification to more services and brand loyalty services. Apple is a 2 trillion-dollar company today, and in the next few years, this is only expected to expand.

What are the effects of transformational leadership?

Transformational leaders are those who inspire their members to achieve beyond their presumed potential. In the same way, these transformed members then go on to become leaders in their own right.

Transformational leaders’ personalized response empowers individuals and helps them to develop their potential. The effects of transformational leadership have a lasting and positive impact.

Research evidence from Psychology Today reported that teams led by transformational leaders have higher levels of performance and report overall high satisfaction than teams led by other styles.

Members develop positive psychological states and find greater meaning in their work. In addition, they also learn to think positively about themselves and the tasks that they are meant to complete.

This results in decreased burnout, social loafing, and increased individual motivation.

Leadership expert Ronald Riggio suggests that this is because of transformational leaders’ unflinching belief that each and every member brings unique talents and skills to a team, and that the voice of each member is important.

He also suggests that the leaders’ strong belief in the vision of the team has a significant impact on the overwhelmingly positive results of the leadership style. By creating a common goal, or vision, leaders enhance the quality of their relationships and create environments that are fair, respectful, and supportive.

It is important to recognize that while this leadership style is extremely effective, there are some team members who will not respond as favorably to transformational leadership. Leaders must adjust their efforts as needed in order to meet their goals.

Implications for managers

While it is important to look at the success and growth of companies and entrepreneurs, it is important to recognize that most of these companies and people did not start out successful.

It is important to recognize that these people and companies were mentored and guided by a transformational leader. The stories here show that this leadership style can help to transform you, your team, and your mission.

What can you do to become a more transformational leader? One of the critical ways to start is by having belief. You must believe in the vision and path you have created, so that you can inspire others to believe in your vision as well. Being charismatic, motivating, and focusing on each individual team member can help you accomplish this through transformative leadership.

Yukl (1994) draws some tips for transformational leadership:
  • Develop a challenging and attractive vision, together with the employees.
  • Tie the vision to a strategy for its achievement.
  • Develop the vision, specify and translate it to actions.
  • Express confidence, decisiveness and optimism about the vision and its implementation.
  • Realize the vision through small planned steps and small successes in the path for its full implementation.

Bass, B. M. (1985) Leadership and Performance beyond Expectations. Free Press, New York.

Bass, B. M. (1990) From transactional to transformational leadership: Learning to share the vision. Organizational Dynamics 18, 19-31.

Bass, B. M. and Avolio, B. J. (1989). Manual for the Multifactor Leadership Questionnaire. Consulting Psychologists Press, Palo Alto.

Bass, B. M. and Avolio, B. J. (1994) Improving Organizational Effectiveness through Transformational Leadership. Sage Publications, Thousand Oaks, CA.

Bass, B. M., Avolio, B. J., & Atwater, L. (1996). The transformational and transactional leadership of men and women. Applied Psychology: An International Review, 45 , 5–34

Bass, B. M., & Riggio, R. E. (2006). Transformational leadership.

Burns, J. M. (1978). Leadership. NY: Harper & Row.

Downton, J. V. (1973). Rebel leadership: Commitment and charisma in a revolutionary process. New York: Free Press.

Yukl, G.(1999). An evaluation of conceptual weaknesses in transformational and charismatic leadership theories. Leadership Quarterly, 10, 285-305; http://dx.doi.org/10.1016/S1048-9843(99)00013-2

Further Information

  • Leithwood, K., & Jantzi, D. (2005). Transformational leadership. The essentials of school leadership, 31-43.
  • Bass, B. M. (1999). Two decades of research and development in transformational leadership. European journal of work and organizational psychology, 8(1), 9-32.
  • Bass, B. M., & Avolio, B. J. (1993). Transformational leadership and organizational culture. Public administration quarterly, 112-121.
  • Bass, B. M., & Steidlmeier, P. (1999). Ethics, character, and authentic transformational leadership behavior. The leadership quarterly, 10(2), 181-217.

Transformational leadership is a leadership style where leaders inspire, motivate, and stimulate their followers intellectually to work towards a shared and valued goal. These leaders encourage innovation, creativity, and personal development among their team members, fostering an environment of trust, respect, and admiration. They aim to transform their followers’ individual and collective consciousness to achieve organizational success.

Which leadership style can resemble transformational leadership because these leaders inspire enthusiasm in their teams and are energetic in motivating others to move forward?

Charismatic leadership style can closely resemble transformational leadership as charismatic leaders inspire enthusiasm and motivate others towards their goals. They use their personal charm and appeal to inspire, energize, and encourage their teams to move forward.

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Institute of Medicine (US) Committee on the Work Environment for Nurses and Patient Safety; Page A, editor. Keeping Patients Safe: Transforming the Work Environment of Nurses. Washington (DC): National Academies Press (US); 2004.

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Keeping Patients Safe: Transforming the Work Environment of Nurses.

  • Hardcopy Version at National Academies Press

4 Transformational Leadership and Evidence-Based Management

Creating work environments for nurses that are most conducive to patient safety will require fundamental changes throughout many health care organizations (HCOs)—in the ways work is designed and personnel are deployed, and how the very culture of the organization understands and acts on the science of safety. These changes require leadership capable of transforming not just a physical environment, but also the beliefs and practices of nurses and other health care workers providing care in that environment and those in the HCO who establish the policies and practices that shape the environment—the individuals who constitute the management of the organization.

Behavioral and organizational research on work and workforce effectiveness, health services research, studies of organizational disasters and their evolution, and studies of high-reliability organizations (see Chapter 1 ) have identified management practices that are consistently associated with successful implementation of change initiatives and achievement of safety in spite of high risk for error. These practices include (1) balancing the tension between production efficiency and reliability (safety), (2) creating and sustaining trust throughout the organization, (3) actively managing the process of change, (4) involving workers in decision making pertaining to work design and work flow, and (5) using knowledge management practices to establish the organization as a “learning organization.” These five management practices, which are essential to keeping patients safe, are not applied consistently in the work environments of nurses.

The committee concludes that transformational leadership and action by each organization's board of directors and senior and midlevel management are needed to fully secure the advantages of these five management practices. Because HCOs vary in the extent to which they currently employ these practices, as well as in their available resources, collaborations with other HCOs can facilitate more widespread adoption of these practices.

This chapter takes a detailed look at the crucial role of transformational leadership and evidence-based management in accomplishing the changes required in nurses' work environments to improve patient safety. We first discuss transformational leadership as the essential precursor to any change initiative. We then review in turn the five management practices enumerated above and describe their uneven application in nurses' work environments. Next, we present several models for evidence-based management in nurses' work environments. Finally, we examine how evidence-based management collaboratives can be used to stimulate the uptake of health care quality improvement practices. During the course of the discussion, we offer four recommendations (highlighted in bold print) for addressing the deficiencies in nurses' work environments through enhanced leadership and management practices.

  • TRANSFORMATIONAL LEADERSHIP: THE ESSENTIAL PRECURSOR

The central function of leadership is to achieve a collective purpose (Burns, 1978). Not surprisingly, leadership has been observed to be the essential precursor to achieving safety in a variety of industries (Carnino, undated), a critical factor in the success of major change initiatives (Baldridge National Quality Program, 2003; Davenport et al., 1998; Heifetz and Laurie, 2001), and key to an organization's competitive cost position after a change initiative. In a study of hospital reengineering initiatives in U.S. acute care hospitals from 1996 to 1997, only the chief executive officer's (CEO) involvement in core clinical changes had a statistically significant positive effect on the cost outcomes of reengineering (Walston et al., 2000). The exercise of leadership has also been associated with increased job satisfaction, productivity, and organizational commitment among nurses and other workers in HCOs (Fox et al., 1999; McNeese-Smith, 1995).

In his Pulitzer Prize–winning, seminal study on leadership, James Burns identifies the essential characteristics of leadership (as distinct from the wielding of power) and distinguishes “transactional” leadership from the more potent “transformational” leadership (Burns, 1978). He stresses that leadership, like the exercise of power, is based foremost on a relationship between the leader and follower(s). In contrast to power, however, leadership identifies and responds to—in fact, is inseparable from—the needs and goals of followers as well as those of the leader. Leadership is exercised by engaging and inducing followers to act to further certain goals and purposes “that represent the values and motivations, the wants and needs, the aspirations and expectations of both leaders and followers” (Burns, 1978: 19). The genius of leadership lies in the manner in which leaders see, act on, and satisfy followers' values and motivations as well as their own.

Leadership therefore can be either transaction-based or transformational. Transactional leadership typifies most leader–follower relationships. It involves a “you scratch my back; I'll scratch yours” exchange of economic, political, or psychological items of value. Each party to the bargain is conscious of the power and attitudes of the other. Their purposes are related and advanced only as long as both parties perceive their individual interests to be furthered by the relationship. The bargainers have no enduring relationship that holds them together; as soon as an item of value is perceived to be at risk, the relationship may break apart (Burns, 1978). This point is illustrated by labor strikes resulting from a change in the terms of work. The compliance of labor with management is based on an acceptable set of transactions; when the transactions are changed, the relationship may not have much to hold it together. Burns notes that in such cases, a leadership act takes place, but it is not one that “binds leader and follower together in a mutual and continuing pursuit of a higher purpose” (Burns, 1978:20). Transactional leadership is not a joint effort of persons with common aims acting for a collective purpose, but “a bargain to aid the individual interests of persons or groups going their separate ways” (Burns, 1978:425).

In contrast, transformational leadership occurs when leaders engage with their followers in pursuit of jointly held goals. Their purposes, which may have started out as separate but related (as in the case of transactional leadership), become fused. Such leadership is sometimes described as “el-evating” or “inspiring.” Those who are led feel “elevated by it and often become more active themselves, thereby creating new cadres of leaders” (Burns, 1978:20). Transformational leadership is in essence a relationship of mutual stimulation and elevation that raises the level of human conduct as well as the aspirations of both the leader and those led, and thereby has a transforming effect on both (Burns, 1978).

Transformational leadership is achieved by the specific actions of leaders. First, leaders take the initiative in establishing and making a commitment to relationships with followers. This effort includes the creation of formal, ongoing mechanisms that promote two-way communication and the exchange of information and ideas. On an ongoing basis, leaders play the major role in maintaining and nurturing the relationship with their followers. Burns notes that, most important, leaders seek to gratify followers' wants, needs, and other motivations as well as their own. Understanding of followers' wants, needs, and motivations can be secured only through ongoing communication and exchange of information and ideas. Leaders change and elevate the motives, values, and goals of followers by addressing their followers' needs and teaching them about their commonly held goals. Doing so may require that leaders modify their own leadership in recognition of followers' preferences; in anticipation of followers' responses; or in pursuit of their common motives, values, and goals.

Although a transforming leader plays the major role in achieving the combined purpose of leader and followers, transformational leadership recognizes that leaders and followers are engaged in a common enterprise and thus are dependent on each other. The premise of transformational leadership is that, regardless of the separate interests people may hold, they are presently or potentially united in the pursuit of higher goals. This point is evidenced by the achievement of significant change through the collective or pooled interests of leaders and followers. The effectiveness of leaders and leadership is measured by the extent to which intended change is actually accomplished and human needs and expectations are satisfied (Burns, 1978).

Burns offers reassurance that transformational leadership is far more common than might be thought, given the above discussion. He notes that acts of transformational leadership are not restricted to (and often are not found in) governmental organizations, but are widespread in day-to-day events, such as whenever parents, teachers, politicians, or managers tap into the motivations of children, students, the electorate, or employees in the achievement of a needed change.

In acute care hospitals, individuals in potential transformational leadership roles range from board-level chairmen and directors; to chief executive, operating, nursing, and medical officers; through the hierarchy to unit managers. In nursing homes, such leadership can come from a facility's owners, administrator, director of nursing, and unit managers. Leadership by these senior organization managers and oversight boards is essential to accomplishing the breadth of organizational change needed to achieve higher levels of patient safety—changes in management practices, workforce deployment, work design and flow, and the safety culture of the organization (see Chapter 1 ).

However, if these individuals rely solely on a traditional, transactional approach to leadership, such substantive changes are likely to be difficult to achieve and sustain, as leaders will need to conduct frequent, ongoing, possibly contradictory renegotiations with workers in response to rapidly changing external forces. In contrast, transformational leadership seeks to engage individuals in the recognition and pursuit of a commonly held goal—in this case, patient safety. For example, individual nurses may desire wide variation in the number of hours they would like to work on a 24-hour or weekly basis. Attempting to secure their commitment to the organization by accommodating all such requests (transactional leadership) despite evidence that extended work hours may be detrimental to patient safety would likely be both time-intensive and unsuccessful. Instead, transformational leadership would engage nursing staff in a discussion of patient safety and worker fatigue and seek to develop work hour policies and scheduling that would put patient safety first and respond to individual scheduling needs within that construct. Such a discussion could have a transforming effect on both staff and management as knowledge was shared.

A leadership approach that aims to achieve a collective goal rather than a multitude of individual goals and aims to transform all workers—both managers and staff—in pursuit of the higher collective purpose can be the most efficient and effective means of achieving widespread and fundamental organizational change. In practicing transformational leadership, leaders need to engage managers and staff in an ongoing relationship based on the commonly held goal of patient safety, and communicate with and teach managers and staff about this higher collective purpose.

When teaching managers about the actions they can take to minimize threats to patient safety, HCO leaders should underscore the five management practices enumerated earlier that have been found to be consistently associated with successful implementation of change initiatives and with the achievement of safety in organizations with high risk for errors. These management practices also underlie all of the worker deployment, work design, and safety culture practices that are addressed in the remaining chapters of this report.

  • FIVE ESSENTIAL MANAGEMENT PRACTICES

“The more removed individuals are from … front-line activities…, the greater is their potential danger to the system” (Reason, 1990:174).

As discussed in Chapters 1 and 2 , latent work conditions have been documented as posing the greatest risk of errors. Therefore, it should not be surprising that errors often have their primary origins in decisions made by fallible system designers and high-level managerial decision makers (Reason, 1990). The corollary to this statement is that these high-level managerial decision makers have a substantial role to play in error prevention—a role that deserves more attention and support.

The concept of evidence-based practice first emerged in clinical medicine and now suffuses the language, decision making, and standards of care of health care clinicians, managers, policy makers, and researchers throughout the world. Evidence-based clinical practice is defined as the conscientious, explicit, and judicious integration of current best evidence—obtained from systematic research—in making decisions about the care of individual patients (Sackett et al., 1996). The use of systematic research findings for evidence-based practice is also supported and applied in the fields of education, criminal justice, and social welfare through the efforts of the international Campbell Collaboration—a sibling of the Cochrane Collaboration that prepares and maintains evidence-based systemic reviews of the effects of health care interventions (The Campbell Collaboration, undated). Evidence-based management , however, is a newer concept—not yet as widely embraced, but just as important (Axelsson, 1998; Hewison, 1997; Kovner et al., 2000; Walshe and Rundall, 2001).

Evidence-based management means that managers, like their clinical practitioner counterparts, should search for, appraise, and apply empirical evidence from management research in their practice. Managers also must be prepared to have their own decisions and actions systematically recorded and evaluated in a way that will further add to the evidence base for effective management practices (Axelsson, 1998).

While health care practitioners have been encouraged and supported in the adoption of evidence-based practice, the same support and encouragement has not been widely available to health care managers for multiple reasons:

  • Organizational research is sometimes esoteric and does not consistently address practical management questions (Axelsson, 1998). Further, research conducted on health care management is limited compared with management research in other industries. The main funders of research in health care (government agencies and private foundations) have historically not funded management research. When large health systems have funded such research, its findings have often been considered proprietary and the results not widely published. As a result, little empirical evidence has been generated about best health care management practices (Kovner et al., 2000).
  • The empirical evidence on effective management practices that does exist is difficult to locate. Management literature is poorly indexed for practical applications and is not easily reviewed and synthesized (Walshe and Rundall, 2001).
  • Many managers are not trained or experienced in the use of such evidence in making management decisions (Kovner et al., 2000). While physicians are trained in a strongly professional model with fairly uniform educational preparation, managers come from a variety of very different professional backgrounds and training. Some management training comes more from long-term practical experience in the workplace, as opposed to formal professional education (Axelsson, 1998; Walshe and Rundall, 2001).
  • Although many health systems spend millions of dollars on consultants for strategic recommendations based on data, they typically underfund their own data systems designed to support decision making and internal management research (Kovner et al., 2000). A study of 14 U.S. hospitals implementing reengineering initiatives in the 1990s found that existing operating budgets often were used to measure progress in meeting reengineering goals, but did not contain baseline statistics managers could use for comparative purposes or identification of causes and effects (Walston and Kimberly, 1997).
  • Some HCOs lack sufficient size and resources to conduct and evaluate applied research (Kovner et al., 2000).
  • Managers' decision-making practices are often quite different from those of health care practitioners. While practitioners' decisions are many in number and made independently, management decisions are often few, large, and made by groups, involving negotiation or compromise and many organizational constraints (Walshe and Rundall, 2001).

For the above reasons, in health care, often “the weapons are ahead of the tactics”—a description used by historian Shelby Foote to characterize military leadership during the U.S. Civil War (Ward et al., 1990). In the case of American health care, the sophisticated medical technology (the weaponry) outclasses the tactics (management) used to organize work and implement change.

Despite the limitations discussed above in the supply of and access to empirical information to guide managerial decision making, there is strong evidence that the management practices enumerated at the beginning of this chapter play a critical role in achieving organizational goals and successfully implementing change within an organization. These five practices are discussed in turn below.

Balancing the Tension Between Efficiency and Reliability

The health care cost-containment pressures of the last two decades (see Chapter 1 ) have forced HCOs to examine their work processes and undertake work redesign initiatives to deliver care more efficiently. Efficiency frequently calls for conducting production activities in as cost-effective and time-efficient a manner as possible. Organizations in many industries often try to accomplish efficiency by downsizing, outsourcing, and cutting costs. Such efficiency measures can be at odds with safety (Carnino, undated; Cooper, 2000; Spath, 2000). For example, when system failures associated with four large-scale disasters (Three-Mile Island, Chernobyl, the Challenger space shuttle, and the Bhopal chemical plant) were compared, subordination of safety to other performance goals was one of 11 common attributes found (Petersen, 1996). HCOs are not immune to these pressures. Concerns have been raised that HCOs, in responding to production and efficiency pressures, may adopt practices that threaten patient safety (Schiff, 2000; SEIU Nurse Alliance, 2001; Thomas et al., 2000).

For example, one of the practices used by high-reliability organizations to increase safety is to consciously incorporate personnel and equipment redundancy into some aspects of work design. This redundancy creates some slack in the system such that if one component in the work production process fails, a replacement will be available to perform the function. Air traffic controllers, for example, are assigned to radar screening in groups of two. While their job functions are somewhat different, each controller acts as a check on the other (Roberts, 1990). This redundancy and other practices characteristic of high-reliability organizations—such as promoting inter- and intragroup communication, cross-training personnel, and attending to the interdependencies of work production processes—might be viewed by other organizations as “frills” (Roberts and Bea, 2001b) and a hindrance to efficient production. In high-reliability organizations, however, performance reliability (safety) rivals productivity as a dominant organizational goal, and such work components are viewed as essentials rather than frills (Roberts, 1990). Organizations can achieve balance between production efficiency and reliability by balancing and aligning their organizational goals; accountability mechanisms; and reward, incentive, and compensation mechanisms (Roberts and Bea, 2001a).

Creating and Sustaining Trust

Creating and sustaining trust is the second of the five management practices essential to patient safety. Trust has been defined as the willingness to be vulnerable to the intentions of another (Mayer et al., 1995; Rousseau et al., 1998) and is strongest when parties believe each other to be competent and to have one another's interests at heart. When trust links people and groups to organizations, it generally makes workers willing to contribute their efforts without expecting an immediate payoff, and increases the extent to which leaders can rely on workers to have the organization's interests at heart (and vice versa). Workers' trust in organizational leaders has been found to be directly related to positive business outcomes, such as increased sales and profitability, and inversely related to employee turnover (Mayer et al., 1995).

Trust has the added advantage of increasing workers' capacity for change by reducing the uncertainty and discomfort with change that otherwise impair individual and group adaptability (Coff and Rousseau, 2000; Rousseau, 1995) and increasing workers' willingness to take risks associated with change (Mayer et al., 1995). Honest and open communication, necessary for successful organizational change, depends on the development of trust throughout the organization (Carnino, undated; DeLong and Fahey, 2000), in part because the level of trust that exists between the organization and its employees greatly influences the amount of knowledge that flows among individuals and from individuals into organization databases, archives, and other records (DeLong and Fahey, 2000). Further, when trust is lacking, participants are less likely to believe what leaders say and to contribute the extra effort, engagement, and knowledge needed to make change successful. It is easier to share information, downplay differences, and cooperate when those involved in a change trust each other.

Trust flows two ways—up and down the hierarchies of organizations. Top-down trust is based largely on competence (Rousseau et al., 1998). Leaders are more willing to entrust subordinates with complete information and with the authority to make decisions when they believe those subordinates to be competent and capable of making and carrying out appropriate decisions. It is well established that leaders manage subordinates differently depending on the employees' perceived competence (Graen et al., 1982; Lowin and Craig, 1968). This is because when hiring, employers put themselves at risk, depending on those they hire to act in ways that help rather than hinder the organization. Employees are hired to act for their employers by making decisions and carrying out responsibilities on the employers' behalf (Pearce, 2000). Employers cope with this vulnerability by attempting to hire employees they can trust and by managing those they hire in ways that sustain that trust. Top-down trust is reinforced whenever leaders have positive exchanges with their employees. Such exchanges are more likely to occur in long-standing relationships in which both parties have made investments in each other, for example, when leaders have developed subordinates who in turn have worked to understand the leader's goals and preferred ways of managing and adjusted their behavior accordingly (Huselid, 1995; Miles and Snow, 1984).

Bottom-up trust, on the other hand, is based in part on workers' perceptions of a manager's or organization's ability, benevolence, and integrity (Mayer et al., 1995). An organization's ability comprises its collective skills, competencies, and expertise. Trust can be fostered by an organization's strong reputation for competence and capabilities, as well as by members' ability to directly access the expertise of others within the organization, the collective capabilities of members, their shared knowledge of each other's expertise, and recognition of “who knows what” based on a history of shared experience (Coff and Rousseau, 2000). Conversely, trust can be damaged by disclosure of failures in competence or by workers' direct observation of instances in which competence falls short of prior expectations.

Bottom-up trust is also based on benevolence, that is, the extent to which managers and organizations are understood by workers to want to do good (aside from a self-concerned or profit motive) for the person who trusts the entity (the trustor). Benevolence gives rise to an attachment between the entity being trusted (the trustee) and the trustor. An example of such a benevolent relationship is that between a mentor and a protégé. The mentor wants to be helpful to the protégé, even though there is no extrinsic reward to the mentor for doing so. Benevolence also has been associated with a trustee's motivation to speak truthfully (Mayer et al., 1995).

The relationship between integrity and trust involves the trustor's perception that the trustee adheres to a set of principles that the trustor finds acceptable (Mayer et al., 1995). In health care organizations, where many workers have strong professional identifications, trust of leadership by subordinates often reflects the extent to which leadership is committed to the values inherent in the professions of medicine and nursing (Bunderson, 2001; Thompson and Bunderson, in press). Conversely, evidence indicates that change initiatives targeting quality improvement are far less likely to generate support when clinical caregivers believe those changes are motivated by either economic or political considerations (Rousseau and Tijoriwala, 1999). Integrity is assessed by the consistency of a party's past actions, credible communication about the trustee from other parties, the belief that the party has a strong sense of justice, and the extent to which the party's actions are consistent with his or her word.

Trust between workers and the organizations in which they work therefore results from the workers' perceptions of the interplay among the organization's ability, benevolence, and integrity. Each of these factors exists to a varying degree along a continuum. Although in the best case, high degrees of trust result from high levels of all three factors, meaningful trust can exist with lesser levels of a combination of the three. The degree of trust between parties also is dynamic and evolves over time as the parties interact. The outcomes that result when a trustor takes a risk and places his or her trust in the trustee affect the degree of trust that exists for subsequent potential interactions (Mayer et al., 1995). Mutual trust is enhanced by positive exchanges that have occurred in the past and are expected to continue in the future (Zucker, 1986). Therefore, trust in organizations also depends to a certain extent on the extent of stability in the relationships that make up the organization (e.g., worker to manager, manager to senior executive). In organizations with high turnover, mutual trust is difficult to achieve (Bryman et al., 1987). In firms in which promotions tend to be internal and the employee development system builds organization-specific capabilities, both workers and managers are more likely to possess common knowledge and similar points of view, and managers are more likely to trust workers (Miles and Snow, 1984). Such bases for trust are less common in many contemporary firms, where external mobility and reduced opportunities for within-firm development mean that organization members, leaders, and workers have fewer shared experiences and frames of reference (Leana and Rousseau, 2000).

It is widely evident that over the course of the twentieth century, senior managers in many industries have come to place greater trust in workers (Miles and Creed, 1995). Employees increasingly have experienced greater discretion and reduced standardization in the way they accomplish their work, coordinated more of their interactions with coworkers and other departments, and reduced their dependence on supervisors for problem solving. At the same time that modern organizational practices presume a higher degree of trustworthiness among workers, however, workers' trust in management remains highly variable (Freeman and Rogers, 1999). In a large-scale survey of the American workforce, Freeman and Rogers found that workers generally reported levels of loyalty to their employer greater than the degree of trust they placed in their employer to keep its promises to them or other workers. This low level of trust is connected to a widespread sense on the part of American workers that they have little influence over workplace decisions. Where workers exercise greater influence over workplace decisions, they are more likely to trust their managers and act in ways that ease implementation of those decisions. With respect to nursing, higher levels of nurse autonomy and control over nursing practice have been associated with greater trust in management among nurses and greater commitment to their employing HCO (Laschinger et al., 2000, 2001b).

Actively Managing the Process of Change

Actively managing the process of change is essential to patient safety because all organizations have difficulty in navigating major organizational change (Kimberly and Quinn, 1984). HCOs are no exception. Despite their vast experience with introducing new medical technologies, HCOs have a history of ineffective attempts at organizational change and remain prone to poor change implementation (Mintzberg, 1997). A large body of research and other published work offers frameworks, models, and guidance for undertaking change (Baer and Frese, 2003; Goodman, 2001; Parker, 1998; Rousseau and Tijoriwala, 1999; Walston et al., 2000). This work consistently calls attention to five predominantly human resource management practices 1 as particularly important for successful change implementation: ongoing communication; training; use of mechanisms for measurement, feedback, and redesign; sustained attention; and worker involvement.

Ongoing Communication

Frequent, ongoing communication through multiple media is a key ingredient of successful organizational change initiatives (Ingersoll et al., 2001). Such communication is a powerful facilitator of change, whereas poor communication creates significant problems (Rousseau and Tijoriwala, 1999). In its work with more than 200 managers from 32 different countries, the Change Program at the International Institute for Management Development in Lausanne, Switzerland, identified employee acceptance of the need for and nature of a change and its effect on their “personal compact” with the organization as a critical determinant of whether change will be successful (Strebel, 1996).

In the present context, it is essential to have ongoing communication with employees about the goals and mission of the HCO, the reasons for change (including contributing economic and policy factors), and the nature of the change (including changes in employee roles and responsibilities). Soliciting feedback about the change throughout its planning, implementation, and continuance is also necessary (Heifetz and Laurie, 2001; Ingersoll et al., 2001). Studies of HCO redesign, reengineering, and reorganization initiatives identify role conflict and ambiguity as consistent issues in change initiatives; nurses who view their roles as ambiguous have lower job commitment (Ingersoll et al., 2001). Clear communication about changes in employee roles and responsibilities can reduce such ambiguity. Even discussions about how the HCO is financed are recommended. In one study, nurses expressed concern about money being available for construction of new buildings even as staff was being admonished to conserve resources. This is a sentiment commonly expressed by those unfamiliar with the multiple sources and allocations of revenue that can exist within an institution (Ingersoll et al., 2001).

When nurse managers in one 700-plus bed hospital undergoing organizational change were asked to rank the behaviors of health care executives in terms of how supportive those behaviors were to the change management process, respondents ranked frequent communication about the goals and progress of organizational change as the most important behavior (Knox and Irving, 1997). Communication between nurses and nurse managers also has been shown to increase nurses' commitment to the organization (McNeese-Smith, 1997), which is essential to weathering the stresses of organizational change.

Because change often requires employees to adopt new roles and responsibilities, training is essential to successful change. This need is not always appreciated, however. A study of 14 U.S. hospitals implementing reengineering initiatives in the 1990s found that needs for new knowledge were often underestimated; the result was periods of deteriorated quality and inefficiency (Walston and Kimberly, 1997). Training is especially needed in such specialized topics as work redesign, knowledge management, error prevention and detection (Spear and Bowen, 1999), and change management itself (Strebel, 1996). In a 1995 survey of nurse leaders in VHA Inc. HCOs and nurse executives and managers belonging to the American Organization of Nurse Executives (AONE), expertise in change management was one of five learning needs reported by the nurse leaders (Gelinas and Manthey, 1997).

Mechanisms for Feedback, Measurement, and Redesign

Few changes in complex organizations work perfectly when first introduced. Virtually all changes require modification over time to achieve optimum results. It is not unusual for organizations, departments, or plants that have implemented innovations most recently to perform worse than those that implemented comparable innovations a year or two before (Macduffie and Pil, 1996). New practices often initially undermine existing routines and competencies and require ongoing learning adjustment, redesign of the change, and supportive efforts to capture the intended benefits of the innovation. Ongoing monitoring, feedback, and redesign are needed to create and sustain effective change (Goodman, 2001; Walston and Kimberly, 1997).

Sustained Attention

Effective organizational transformations require long periods of time and constant effort. Macduffie and Pil (1996) point out that in the auto industry, plants in the first year following adoption of a new work system struggle with the right mix of incentives, managerial supports, and training needs, and experience coordination difficulties with other units. Those that sustain the change into the second year begin to see cost and quality improvements. The above-cited study of 14 U.S. hospitals implementing reengineering initiatives in the 1990s found that 2 to 3 years into their reengineering efforts, many had yet to implement a number of their initial plans. Although difficulties arose during the long implementations, the transition from implementation to a sustained, institutionalized process was even more problematic. While most study participants perceived reengineering to be an ongoing change process, and managers realized that continual effort was needed to move reengineering forward, many ended their efforts or decreased them after initial implementation. Without continued attention, the change was not sustained. The hospitals that were able to sustain a change were those that embedded the new initiative within ongoing operations, such as a continuous quality improvement or total quality management process, or established specific, measurable goals and mechanisms to track their progress. In two cases in which tracking measures were employed, the “established goals and feedback monitors appeared to galvanize the organization to make and maintain changes in these areas” (Walston and Kimberly, 1997:158).

Codifying a change to ensure consistency of application and direction through implementation manuals, guidelines for decision making, and provision of budgetary support has been identified as a critical ingredient in successful and sustained implementation (Walston et al., 2000). Credible commitment to stay with the change over time in the face of personnel changes or economic factors is especially important in organizations with a history of dysfunctional labor–management relations and ineffective change management (Heller, 2003). Such commitment can take the form of public statements and written documents articulating the agreement.

Worker Involvement

Evidence from multiple studies indicates that change is typically turbulent and difficult for staff members (Ingersoll et al., 2001; Strebel, 1996). Changes often affect worker roles and responsibilities, work group relationships, and resource availability and use. Consequently, a natural human response is to react negatively to the challenges created by change. This negativity can be overcome by actively involving workers in the planning and design of a change and providing them with information about the progress being made in achieving the goals of the redesign (Walston and Kimberly, 1997). The importance of such worker involvement is discussed in greater detail below.

Involving Workers in Work Design and Work Flow Decision Making

Evidence indicates that a highly bureaucratic structure, so useful in organizations into the early twentieth century, is inappropriate to many organizations today (Ciborra, 1996; Ilinitch et al., 1996) because both human potential and technology have matured since the beginning of the Industrial Revolution. Organizational structures that are strongly hierarchical in design with resultant hierarchical decision making are hampered in their ability to respond to situations with high variability (Moorman and Miner, 1998; Quinn, 1992) and are associated with reduced safety (Roberts and Bea, 2001b). Since the 1980s, a worldwide evolution has taken place in the organizing principals of manufacturing, as the mass production system (which itself replaced the old craft system in the early twentieth century) was transformed at the end of the 1900s into the flexible production system (Macduffie and Pil, 1996). This flexible production system was enabled and reinforced by two related forces: managers' expanded trust in their workers and an ever-greater reliance on workers as the basis for organizational success (Miles and Creed, 1995).

The relationship between greater reliance on workers and organizational success is being documented across a variety of industries and types of research. Studies of high-reliability organizations show that effective decision making is flexible decision making, pushed to the lowest level commensurate with available knowledge (Bigley and Roberts, 2001; Roberts et al., 1994; Weick and Roberts, 1993). For example, any level of military personnel on an aircraft carrier can call a halt to a flight operation if he or she sees what looks like a dangerous situation (Roberts, 1990). Health services research supports these findings. The above-cited study of 14 U.S. hospitals implementing reengineering initiatives in the 1990s found that involving the total organization in the reengineering process was frequently mentioned as an important factor in success and, conversely, that inconsistent involvement was a barrier (Walston and Kimberly, 1997). Nurses working in organizations whose work culture emphasized decentralized decision making reported significantly higher commitment to the organization, empowerment, and job satisfaction and significantly lower intent to leave (Gifford et al., 2002).

Such high-involvement work systems have been described across a number of industries. They are characterized by shifting more decisions down the organization's hierarchy to the level of individual workers or teams of workers, increasing worker responsibility for quality control (monitoring safety and taking action to prevent risks to safety or quality), and broadening the knowledge workers possess about the activities of other work groups (e.g., through cross-functional teams). Such work systems promote greater contributions on the part of workers to the value of the organization by releasing underutilized worker competence (Edmondson, 1999; Frese et al., 1999; Ho et al., 1999; MacDuffie, 1995; Parker, 1998). Preconditions for implementing such systems include a relationship of trust between senior leadership and workers (Rousseau and Tijoriwala, 1999) and credible commitment on the part of leadership to persist with implementing high-involvement work systems over time.

In nursing research, this involvement in decision making has been studied under a number of constructs, including shared governance, nursing empowerment, control over nursing practice, and clinical autonomy. These constructs have certain common elements.

Shared governance—“a decentralized approach which gives nurses greater authority and control over their practice and work environment [emphasis added]” (O'May and Buchan, 1999:281)—began to be incorporated into nurse work environments in the late 1970s. The results of these efforts are uncertain because of the lack of a uniform definitional construct, wide variation in implementation models, infrequent evaluations, and poorly designed evaluation methodologies. “As a result, studies to evaluate shared governance tend to yield mixed results, leave questions as to what has been evaluated, and often produce little opportunity for cross-comparison of results” (O'May and Buchan, 1999:292).

Nursing research on empowerment similarly has not generally included a uniform operational definition of this construct, but has described empowerment in terms of its goal (i.e., “empower nurses to exercise more control over the content and context of their practice ” [emphasis added]) and in terms of the resources needed to achieve it (i.e., “the ability to access and mobilize support, information, resources, and opportunities from one's position in the organization”) (Laschinger and Havens, 1996:27–28). Conger and Kanungo (1988:474) define empowerment as “a process of enhancing feelings of self-efficacy among organizational members through the identification of conditions that foster powerlessness and through their removal by both formal organizational practices and informal techniques of providing efficacy information.” A series of studies of nurses employed at individual Canadian and U.S. hospitals found that perceived empowerment is strongly related to perceptions of autonomy and control over nursing practice (Laschinger and Havens, 1996; Sabiston and Laschinger, 1995). Additional studies in this series found higher levels of organizational trust among nurses reporting greater workplace empowerment (Laschinger et al., 2000, 2001a). Evidence also indicates that organizational structures that foster nurses' empowerment (combined with strong managers) may be important factors in increasing the organizational commitment of nurses working in nursing facilities (Beaulieu et al., 1997).

Studies of shared governance and empowerment highlight nurses' control over their practice as a key element. The construct of control of nursing practice has been addressed more explicitly and fully in studies seeking to determine the attributes of hospitals that are rated by their nurses as making them “good place to work” and that do not experience difficulties in attracting and retaining nurses. These hospitals (referred to as “magnet hospitals”) have been the subject of multiple studies. A distinction is made in these studies between control over nursing practice and clinical autonomy. Clinical autonomy refers to nurses' ability to assess individual patient needs and practice nursing care appropriate to those needs, that is, their ability to make independent clinical decisions and define the scope of practice in relationship to patients in their care (Kramer and Schmalenberg, 2003; McClure et al., 1983; Scott et al., 1999). Autonomy is a characteristic commonly identified by staff nurses, nurse managers, and chief nurse executives (CNEs) as important to a magnet hospital (Aiken, 2002; McClure et al., 1983). Control over nursing practice is defined as nurses' ability to shape not just the care of an individual, but also the organizational policies and practices to be followed within nursing units and the HCO overall that affect nursing care, as well as to control the resources need to provide that care (Hinshaw, 2002). Control over nursing practice represents an organization-level (as opposed to patient-level) autonomy, in which staff nurses, nurse managers, and CNEs take part in hospital policy and decision making about professional practice and patient care (Scott et al., 1999). A review of studies conducted on magnet hospitals reveals that both autonomy and control over nursing practice are consistently identified as magnet characteristics (Scott et al., 1999). Other research suggests that nurses' autonomy and control over their practice environment are positively associated with their trust in management (Laschinger et al., 2001b).

Creating a Learning Organization

The final evidence-based management practice calls for all HCOs to become learning organizations. The ongoing acquisition and management of knowledge has been identified as one of the intrinsic characteristics of high-performing organizations in postindustrial societies (Quinn, 1992). Economists and business strategists point to how an organization manages its knowledge assets as more important to its competitive advantage in today's economy than how it manages bureaucratic control of its capital resources (Blackler, 1995; DeLong and Fahey, 2000). Continuous organizational learning also has been documented as playing a central role in the development and maintenance of safety in organizations (Carnino, undated). This point is particularly salient to a high-tech industry such as health care, which is characterized by rapidly accelerating scientific and technologic advances. The Institute of Medicine (IOM) report Crossing the Quality Chasm: A New Health System for the 21st Century (IOM, 2001), cites this growth in health care knowledge, drugs, medical devices, and technologies as one of the four defining attributes of the U.S. health system affecting health care quality.

A learning organization is an organization “skilled at creating, acquiring, and transferring knowledge, and at modifying its behavior to reflect new knowledge and insight” (Garvin, 1993:80). Learning organizations do not passively wait for knowledge to present itself, but actively manage the learning process by taking advantage of all sources of knowledge, using systematic experimentation to generate new knowledge internally, and transferring knowledge quickly and efficiently throughout the organization (Garvin, 1993). These processes are used to create better work tools, processes, systems, and structures in order to improve the organization's production processes (DeLong and Fahey, 2000).

Actively Managing the Learning Process

Taking advantage of all sources of knowledge Learning organizations know that knowledge can come from many sources, including internal flashes of creativity or insight, knowledgeable experts within the organization, external experts, the best practices of other organizations, and other sources. They learn from their own and others' experiences by reviewing past organizational successes and failures, assessing them systematically, and recording them in a format that employees can easily access (Garvin, 1993). Learning from the experiences and best practices of others is a major factor in the success and sizable cost savings of a number of organizations' reengineering initiatives (Stewart, 1999), although knowledge gained from failures can often be the most helpful (DeLong and Fahey, 2000). However, knowledge from these sources serves as a starting point only; organizations are expected to test and improve upon it through continual experimentation (DeLong and Fahey, 2000).

Using systematic experimentation to generate new knowledge internally Experimentation is widely recognized as a cornerstone of a learning organization. Experimentation involves the systematic searching for and testing of new knowledge using the scientific method through an ongoing series of small experiments, designed to produce incremental gains in knowledge access (Garvin, 1993). It can be undertaken on existing programs or on planned new demonstration projects. This application of the scientific method in a continuing series of controlled experiments has been identified as the hallmark of the Toyota Production System, which has been widely hailed as a benchmark work system (see Box 4-1 ). Toyota teaches the scientific method to workers at every level of the organization, thereby creating a “community of scientists” (Spear and Bowen, 1999).

The Toyota Production System. The Toyota Production System (TPS) has long been hailed as the reason for the Toyota Company's outstanding performance and has been used as a model by many other organizations around the world. In essence, the TPS creates (more...)

Other knowledge management organizations, while perhaps not using the scientific method as rigorously as the Toyota System, employ similar methods associated with continuous quality improvement or total quality management. These methods include employing the “plan–do–check–act” cycle; insisting on data, rather than assumptions, for decision making; and using simple statistical analysis tools, such as histograms, pareto charts, and tests of correlations, to organize data and raw inferences. These methods help the organization and its employees become more disciplined in their thinking and more attentive to details of work processes and production (Garvin, 1993).

Transferring knowledge quickly and efficiently throughout the organization Learning organizations spread knowledge quickly and efficiently throughout the organization. They know that ideas have the greatest impact when they are shared broadly rather than tightly held by a few individuals, and that knowledge must be transferred through multiple, reinforcing channels to create synergy and enhance its absorption and application. A variety of knowledge dissemination mechanisms can promote this transfer, including written, oral, and visual reports; site visits and tours; personnel rotations; and education and training programs. Each of these mechanisms, however, can be a cumbersome way to transfer knowledge. Active experience in performing a new activity is much more effective (Garvin, 1993); some research indicates that knowledge is exchanged in direct proportion to the level of face-to-face contact (Davenport et al., 1998). For this reason, personnel rotations have been identified as one of the most powerful methods of transferring knowledge (Garvin, 1993). It is important to note that such face-to-face knowledge transfers depend on a stable organizational workforce. A relatively stable workforce permits members to hold common understandings of important organizational priorities and processes and adequate information regarding the people and places in the organization where specific knowledge resides (Coff and Rousseau, 2000).

Knowledge management and organizational learning also are found to be more successful when they are supported by information technology (Davenport et al., 1998; Hansen et al., 1999). However, the type and extent of information technology needed vary according to the predominant knowledge management strategy in use. In a study of knowledge management practices at management consulting firms, HCOs, and computer manufacturers, researchers found that organizations that produced relatively standardized products to meet fairly standard needs relied heavily on codified knowledge stored in databases where it could easily be used by anyone in the company (Stewart, 1999). This capability required a heavy investment in information technology. Alternatively, organizations that provided more customized services to address unique problems tended to rely more on person-to-person sharing of knowledge and used information technology primarily to help people communicate (Hansen et al., 1999).

HCOs are likely to provide both standardized and customized services, and must adapt their knowledge management strategies to their settings and particular needs. In all cases, it can be important to avoid overreliance on information technology at the expense of shared personal knowledge through face-to-face contact (Goodman and Darr, 1996).

Time Required to Create a Learning Organization

The creation of a learning organization first requires an organizational commitment to learning through the establishment of a culture conducive to knowledge creation, sharing, and use—a knowledge-friendly culture (DeLong and Fahey, 2000; Garvin, 1993). Yet research on more than 50 companies pursuing knowledge management projects revealed that organizational culture was the major barrier to creating a learning organization (DeLong and Fahey, 2000). This situation will not be remedied overnight; most successful organizational learning and knowledge initiatives are the product of carefully cultivated attitudes, commitments, and management processes that have been built up slowly and steadily over time. The Toyota Production System, discussed earlier (see Box 4-1 ), is the product of decades of work (Spear and Bowen, 1999).

On the other hand, some changes can be made immediately to foster an environment conducive to learning. These include assessing the existing knowledge culture within an organization; freeing up employee time for thinking, learning, and training; and aligning incentives to reinforce and facilitate uptake of knowledge management practices.

Assessing the existing knowledge culture within the organization Companies whose cultures are most effective at creating new knowledge and integrating it into the organization have norms and practices that demand broad participation in knowledge gathering and distribution (DeLong and Fahey, 2000). Some organizations, however, favor individual knowledge over group or organizational knowledge. In these organizations, individual knowledge is associated with power, control, and security of one's position in the organization. When employees believe that sharing what they know poses personal risk and decreases power, the free exchange of knowledge is impeded (Davenport et al., 1998). Before undertaking a knowledge management initiative, therefore, management should assess the culture of its organization to determine existing attitudes toward ownership of knowledge and how those attitudes would be altered by the initiative. Depending on the results of that assessment, management might also need to adopt new behaviors to communicate a shift from valuing individual over collective knowledge. It is necessary as well to make explicit what practices need to change to promote more collaborative use of knowledge (DeLong and Fahey, 2000).

In addition, organizations should examine their internal communication patterns. Communication patterns that make executives accessible and approachable and encourage open and frank dialogue are an essential element of a learning organization. Questioning fundamental beliefs and existing ways of working is difficult for organizational leadership, but is usually a key step in creating new knowledge for the organization. Intense debate on key strategic issues, drawing on extensive and intensive internal and external inputs—sometimes called “constructive confrontation” or “ferocious arguing with one another while remaining friends”—is identified as a key characteristic of cultures that are relatively effective at creating and integrating new knowledge. Learning organizations must identify norms and practices that are barriers to discussing sensitive topics, find and evaluate evidence about the extent to which senior management is perceived as accessible and approachable, and identify the norms and practices within the organization that encourage high frequency of interaction and the expectation of collaborative problem solving. Although the senior executive ultimately must make a decision not everyone will like, the process for engaging and listening to many views on an issue increases the likelihood of a better decision and broader acceptance of the decision once made (DeLong and Fahey, 2000).

Shared information is enhanced by familiarity, that is, where people know each other and the conditions under which they work. Familiarity can be compromised by status or other differences that suppress interaction (Goodman and Garber, 1988; Goodman and Leyden, 1991). As a result, people from different parts of the organization and different status levels often find it difficult to share knowledge. Such boundaries inhibit the flow of information; they keep individuals and groups isolated and reinforce preconceptions. A solution to this problem is to break down boundaries and stimulate the exchange of ideas between individuals at multiple levels of the organization through formal and informal practices that bring people together for this purpose (DeLong and Fahey, 2000). Conferences, meetings, and project teams that cut across organizational levels promote a fresh flow of ideas and the chance to consider competing perspectives (Garvin, 1993).

Providing time for thinking, learning, and training For knowledge to be created and adopted, employees must have sufficient time for reflection and analysis to assess current work systems and devise new work processes. Such learning is difficult when employees are harried or rushed; it tends to be displaced by the pressures of the moment. Only if top management explicitly frees up employee time for this purpose does learning occur with any regularity.

Further, employees must posses the skills to use learning productively. To perform and evaluate experiments, managers and staff members need skills in such areas as statistical methods and experiment design in order to perform and evaluate experiments. These skills are seldom intuitive and must be learned. Such training is often most effective when intact work groups participate in the training together. Training in brainstorming, problem solving, evaluation of experiments, and other core learning skills is essential (Garvin, 1993). All of the organizations managed according to the Toyota Production System, for example, share an overarching belief that people are the most significant corporate asset and that investments in their knowledge and skills are necessary to build competitiveness. They invest heavily in training and in creating among coworkers shared understandings of problem solving and innovation processes (Spear and Bowen, 1999).

Organizations need to create formal programs or events with explicit learning goals in mind. These programs can take a variety of forms, including strategic reviews that examine the changing external environment and the organization's services, technology, and market position; systems audits that review the performance of the large processes and delivery systems in the organization; internal benchmark reports that compare the organization's performance with that of other best-practice organizations; the results of “study missions” in which individuals are dispatched to leading external organizations to better understand their performance and distinctive skills; and symposiums that bring customers, suppliers, outside experts, and internal groups together to share ideas and learn from one another. Each of these activities fosters learning by requiring employees to grapple with new knowledge and consider its implications for the organization (Garvin, 1993).

Aligning incentives to reinforce and facilitate uptake of knowledge management practices Knowledge has been described as being “intimately and inextricably bound with people's egos and occupations” and therefore as not flowing easily across roles or functional boundaries (Davenport et al., 1998:53). Knowledge is more likely to be transferred effectively when the right incentives are in place (Garvin, 1993). In a study of 31 knowledge management projects at 24 corporations, the motivation to create, share, and use knowledge was found to be a critical success factor for the projects. The researchers concluded that incentives to contribute should be long-term and should be linked to both the general evaluation and compensation structure of the organization (Davenport et al., 1998). Some organizations have used the extent to which employees contribute to the organization's knowledge repository as a component of employee evaluations and compensation decisions (Davenport et al., 1998). The U.S. Army is one of a growing number of organizations that formally consider knowledge-sharing capabilities when identifying candidates for promotion (DeLong and Fahey, 2000).

  • UNEVEN APPLICATION OF EVIDENCE-BASED MANAGEMENT PRACTICES IN NURSES' WORK ENVIRONMENTS

While some nurses have had firsthand experience with the successful application of the above evidence-based management practices in their workplace, this has not consistently been the case. Concerns about changes in nursing leadership, increased emphasis on production efficiency in response to cost-containment pressures, weakened trust, poor change management, limited involvement in decision making pertaining to work design and work flow, and limited knowledge management are all found in nurses' work environments. Each of these barriers to the application of evidence-based management practices in nurses' work environments is discussed in turn below.

Concerns About Changes in Nursing Leadership

Nursing leadership in hospitals and other HCOs has a key role with respect to the deployment of the nurse workforce in these institutions and overall patient care. This role, however, at least in hospitals, is changing. Evidence suggests that these changes may diminish the ability of hospital nursing leadership to (1) represent nursing staff and management to each other and facilitate their mutual trust, (2) facilitate the input of direct-care nursing staff into decision making on the design of work processes and work flow, and (3) provide clinical leadership in support of knowledge acquisition and uptake by nursing staff.

The senior nurse leadership position in hospitals has not always been an executive-level position. A 1983 national Commission of Nursing report and publications of the American Hospital Association recommended to hospitals that chief nursing officers (CNOs) be regarded as a key component of a hospital's executive management team. 2 Prior to this time, CNOs typically were not involved in strategic planning for the hospital overall; many did not participate in the development of the budget for their own department. Recommendations that nurses be involved in policy development and decision making throughout the organization were important in bringing the CNO position to the executive management team in many hospitals (Clifford, 1998).

This view of the CNO position is consistent with both old and new management concepts. Florence Nightingale, the founder of modern nursing, made major improvements in the education and training of nurses in the latter part of the nineteenth century. She proposed an administrative system for hospitals that included a triad of lay administrator, physician leader, and senior nursing leader. Her model was an important contributor to the development of hospital management systems and was responsible for the introduction of the position of superintendent of nurses to U.S. hospitals. Nightingale asserted that only those trained as nurses were qualified to govern other nurses (Clifford, 1998). This view also is consistent with the more recent management philosophy embodied in the Toyota Production System, which requires that all managers know how to perform the jobs of those they supervise (Spear and Bowen, 1999). Until recently, the CNO was the official leader of a hospital's nursing staff. Although other administrative responsibilities may have been involved, the primary role of the CNO was the administration and leadership of the nursing service (Clifford, 1998).

In the past two decades, the role of the CNO has continued to expand as a result of service integration and hospital reengineering initiatives. In surveys conducted in 1993 and 1995 of nurse leaders in VHA, Inc. (a nationwide network of community-owned health care systems) and nurse executives and managers who were members of the AONE, 80 percent of all respondents reported changes in their role. Nearly all of these respondents identified expanded responsibilities as a major feature of their role change. The proportion of respondents holding positions whose title included the word “nursing” (e.g., director of nursing or vice president of nursing) declined from 55 to 24 percent, while the proportion holding positions whose title did not explicitly mention nursing (e.g., vice president of patient care, vice president of operations, and chief operating officer) increased from 35 to 53 percent. The new, expanded roles of these hospital nurse leaders included responsibilities for radiology departments, surgery, emergency departments, cardiology, nursing homes, outpatient services, admitting, and infection control units (Gelinas and Manthey, 1997). A more recent, 1997–1998 study of hospital restructuring in 29 university teaching hospitals found that the CNE position had been transformed into a “patient care” executive position in 97 percent of the institutions surveyed (Sovie and Jawad, 2001).

Even as CNOs have increasingly assumed these expanded managerial duties, they also have retained responsibility for managing nursing services. Research is needed on whether the expanded role of the CNO has beneficial or adverse effects on patients (Clifford, 1998). Some assert that expanding the CNO role increases senior nurse executives' influence in desirable ways. Others express concern that the expansion of the CNO's areas of responsibility beyond those directly associated with clinical nursing takes attention away from nursing care and hinders the development of strong nursing leadership for nursing practice in the hospital. What is agreed upon is that as the roles of nurse leaders have expanded, so have the demands of balancing two, often competing, sets of responsibilities as senior administrative staff and leader of nursing staff. As senior executive, the CNO must help the hospital meet its strategic goals, which are often financially focused. As leader of nursing staff, the CNO is responsible for providing clinical leadership. Concern has also been expressed that the attempt to meet both sets of responsibilities has resulted in the potential loss of a common voice for nursing staff and a weakening of clinical leadership.

Potential Loss of a Common Voice for Nursing

A 1996 qualitative study of the changing role of hospital CNOs in the not-for-profit flagship hospitals of three urban integrated delivery systems chosen by a panel of experts as being “at the forefront of change” found that at these hospitals, the organizational boundaries of nurse leaders had shifted away from the traditional department of nursing to an organizational structure in which nursing services were unidentifiable and integrated. An expansion of management responsibilities appeared to be taking place in all nursing management roles, in one hospital resulting in the “dismantling of the nursing department.” That is, an identifiable central nursing department was no longer visible in the restructured hospital, as was manifest in the absence of nursing as an organizational element on the hospital organization chart. Moreover, fewer nurse managers, directors, and assistant nurse managers were found at all levels of the hospitals (Clifford, 1998).

This phenomenon has been documented to occur on a more widespread basis. In the previously cited 1993 and 1995 surveys of nurse leaders in VHA, Inc. HCOs and AONE nurse executives and managers, nearly one-third of all respondents indicated that after their redesign initiatives, there would no longer be a separate department of nursing (Gelinas and Manthey, 1997). Hospital staff nurses further affirm these findings. An examination of changes in the work environments of nurses in 12 hospitals identified as having characteristics associated with high rates of nurse retention found that from 1986 to 1998, the percentage of nurses reporting “a chief nursing executive equal in power/authority to other top hospital officials” declined from 99 to 69 percent. Those reporting “a director of nursing highly visible and accessible to staff” fell from 89 to 41 percent (Aiken et al., 2000). A more recent, 1998–1999 survey of nurses working in acute care hospitals in Pennsylvania additionally found that 58.3 percent of nurses reported a decrease in the number of nurse managers, and 16.8 percent reported the loss of a CNO without replacement (Aiken et al., 2001). The potential loss of the ability of these nursing leaders to represent staff nurses is articulated in a report on the findings of interviews with executives of 13 VHA, Inc. HCOs conducted in 1992. The nurse authors of the report state:

It was not uncommon to find nursing personnel reporting to non-nurse administrators, and former nurse executives responsible for non-clinical, non-patient care departments…. Nurse executives are fulfilling a variety of roles previously considered strictly administrative, including those of chief operating officer and CEO. In this capacity, it is inappropriate for them to be spokespersons for the nursing profession within their institution—they must be spokespersons for the broad function of patient care. Although this bodes well for improvements in patient care, it also dislocates the strongest voice for professional nursing issues. For the past 20 years or so, nurse executives have been spokespersons for the profession at the institutional, local, state, and national levels, both as individuals and through their organizations and associations. Because of the dramatic role changes underway, the ability of this group to effectively represent the nursing profession may be seriously compromised. The nursing profession may be well-advised to find leaders from other settings—practice, education, or research. (Gelinas and Manthey, 1995:63)

Weakening of Clinical Leadership

Leadership for the clinical practice of nursing also has been identified as at risk. In the above-cited 1996 qualitative study of the changing role of hospital CNOs in three not-for-profit flagship hospitals, changes in the clinical leadership role of the CNO were found not to have kept pace with the growth and strength of the administrative responsibilities of that role. Similar changes were experienced down the line. The span of control of the midlevel director of nursing increased, and the incumbent had less time to spend with individual unit managers. Unit managers had less ready access to the midlevel director of nursing. They no longer had someone to whom they could readily turn to help them reflect on problems and issues requiring their attention. Similarly, the nurse unit managers' span of control had increased. Some nurse managers were now responsible for more than one patient care unit as the number of nurse managers in these three hospitals decreased (Clifford, 1998).

These findings echo those of interviews with executives of 13 VHA, Inc. HCOs beginning in 1992. These executives reported that in organizations that had retained a traditional nursing structure, the number of nursing directors and nurse managers had been reduced. Nurse managers were often assigned responsibility for two nursing units, with an expansion in the number of assistants or charge nurses reporting to them at the shift level (Gelinas and Manthey, 1995). These additional duties likely leave the nurse manager with less time to provide clinical supervision or teaching (Norrish and Rundall, 2001).

Interview data from all three flagship hospitals in the 1996 study suggest the need for an ongoing, central locus of clinical leadership within the HCO (Clifford, 1998). And in the 1997–1998 survey of 29 university teaching hospitals described above, researchers found that as the responsibilities of nurse executives were expanded, consolidation or downsizing of nursing departments occurred in 82 percent of hospitals. Further, nurse manager positions were reduced in 91 percent of the hospitals, and nurse managers' span of control was broadened to include more than one patient care unit. Nearly half of the nurse managers were also given additional responsibility for supervising personnel other than nursing staff (e.g., housekeepers, transportation staff, dietary aides). Assistant nurse manager positions were reduced in 68 percent of the hospitals. “The cumulative effect … was a reduction in the direct management support available to patient care staff” (Sovie and Jawad, 2001:591). This effect also is reported in other studies of HCO reorganization of nursing services (Ingersoll et al., 2001).

The committee finds that strong nursing leadership is needed in all HCOs in order to (1) represent nursing staff and management to each other and foster their mutual trust, (2) facilitate the input of direct-care nursing staff into decision making on the design of work processes and work flow, and (3) provide clinical leadership in support of knowledge acquisition and uptake by nursing staff. Recent changes in the responsibilities of senior nurse executives and nursing management in hospitals, in particular, may place these functions at risk. The committee therefore makes the following recommendation:

Recommendation 4-1. 3 HCOs should acquire nurse leaders for all levels of management (e.g., at the organization-wide and patient care unit levels) who will:

  • Participate in executive decisions within the HCO.
  • Represent nursing staff to organization management and facilitate their mutual trust.
  • Achieve effective communication between nursing and other clinical leadership.
  • Facilitate input of direct-care nursing staff into operational decision making and the design of work processes and work flow.
  • Be provided with organizational resources to support the acquisition, management, and dissemination to nursing staff of the knowledge needed to support their clinical decision making and actions.

Although the committee did not find evidence supporting the use of one particular organizational structure for locating nursing leadership within any one type of HCO or across all HCOs, the intent of this recommendation is to institute (among other management practices) well-prepared clinical nursing leadership at the most senior level of management—e.g., CEO's direct reports—commensurate with physician leadership within the HCO.

Increased Emphasis on Production Efficiency

Many of the changes in nursing leadership described above were the result of organizational efforts to achieve greater efficiency (Sovie and Jawad, 2001). This increased emphasis on production efficiency (discussed also in Chapter 1 ) has been a hallmark of the hospital and health care reengineering initiatives of the last two decades (Bazzoli et al., 2002), particularly with respect to the work of nurses (Norrish and Rundall, 2001). In the 1993 and 1995 surveys of nurse leaders discussed above, although fewer than 17 percent of respondents identified cost reduction as a primary reason for their hospital's redesign initiative, “reduction of costs” was the criterion employed most frequently to evaluate the outcomes of the initiative (reported by 90 percent of respondents) (Gelinas and Manthey, 1997). Concern that reorganization initiatives have focused on efficiency at the expense of patient quality also are commonly expressed by nursing staff involved in such initiatives (Barry-Walker, 2000; Ingersoll et al., 2001).

Experts in patient safety have identified safeguards that can be used by HCOs to defend against an overemphasis on efficiency at the expense of reliability (patient safety). First, HCO boards of directors should spend as much time overseeing an organization's patient safety performance as they do dealing with financial goals and performance (Appleby, 2002). They should know (1) how patient safety is addressed in the HCO's mission statement; (2) what mechanisms are used by the HCO to assess the safety of its patient care environment; and (3) what the HCO's overall plan or approach is for ensuring patient safety and whether it has defined objectives, senior-level leadership, and adequate personnel and financial resources. The board should also receive regular progress reports on patient safety (Mohr et al., 2002) and review all sentinel events and the organization's follow-up activities (Appleby, 2002). Further, a member of the HCO's senior leadership team (excluding risk management) should serve as chief quality and safety officer, comparable to the chief financial officer. Just as the latter individual is in charge of monitoring and strengthening the organization's financial performance, the chief safety officer should be responsible for patient safety measures and metrics (Appleby, 2002). This responsibility can be met by developing indicators of patient safety and quality that are collected and monitored before and after change initiatives are undertaken (Ingersoll et al., 2001).

Weakened Trust

Weakened trust has been widely observed by researchers studying and comparing hospitals as part of a national recognition program for hospitals that have achieved high levels of nurse retention (Kramer and Schmalenberg, 1993:62): “As we have visited and studied nursing departments all over the country, we have been struck by the amount of distrust perceived by nurses—not only from physicians but also from nurse managers and administrators.” The researchers contrast this situation with the work environment observed at one hospital (Edward Hospital in suburban Chicago), where high levels of trust were present:

At EH we observed some of the most flagrant disregard for the “on paper” bureaucratic structure that we have ever seen. Repeatedly, when asked how they would handle a situation, nurses told us that it depended on the situation, but that they felt free to ignore the formal structure if the situation demanded it. The perception of openness and trust was almost unbelievable; there was absolutely no reticence to share anything with us—good or bad. “We can say what we think and feel; I know that nothing bad will happen to me if I do.” Nurses talked openly and freely about failures, faults and mishaps, as well as about the positive things in the organization. Not a single nurse asked that any of our interview material be kept confidential. This open and trusting atmosphere is remarkable, especially because of its scarcity. (Kramer and Schmalenberg, 1993:62)

Loss of trust in administration by nursing staff is frequently reported in studies of HCO redesign and reorganization initiatives that have taken place in the last two decades (Decker et al., 2001; Ingersoll et al., 2001). The above-cited 1996 qualitative study of the changing role of hospital CNOs in the not-for-profit flagship hospitals of three urban integrated delivery systems found that loss of trust on the part of nursing staff was acutely felt and attributed to changes in the role of the CNO. These changes affected the relationships of CNOs with nurse managers, which were perceived as characterized by a growing distance. “Whether the change was actual or symbolic did not matter; the distancing was felt.” The nurses needed to trust that someone who understood their practice was advocating at the highest levels of the organization for what they were doing on behalf of patients and families (Clifford, 1998:111).

Other reports of loss of trust during reengineering initiatives are frequently associated with poor communication practices. In a study of major reorganization at two acute care hospitals, loss of a trusting relationship with administration was reported as stemming from a perception (constant across hospitals and nursing units) that information was being withheld and that administrators were not aware of the circumstances that existed at the nursing unit level (Ingersoll et al., 2001). A study of reengineering efforts at 14 U.S. hospitals provides examples of poor communication patterns that reduced employees' trust in the administration:

Many hospitals promised that there would be no “sacred cows” or areas that would be exempt from reengineering examination. In reality, however, almost every hospital exempted certain areas. One major vendor was also a major donor to the hospital and was excluded. A specialized service area earned too much income to be disturbed and was declared off-limits. A physician was too powerful to be challenged. It seemed that every hospital had some idiosyncratic situation that prevented full participation. The promise of full participation, followed by selective exemptions, resulted in increased cynicism and damaged trust. (Walston and Kimberly, 1997:157)

Honesty with communication is also important … executives would initially communicate through the planning process that quality and employees' jobs would be protected but, when implementation occurred, employees felt both were affected. One chief financial officer in the final stages of planning his reengineering project told us he did not think that they had been totally honest about what was going to happen as he anticipated a large layoff, but they had not been allowed to even use the words layoff or severance. (Walston and Kimberly, 1997:156)

As a result of these poor communication patterns, trust was low, and employees repeatedly disregarded information. Hospitals reported that employees would regularly discard internal communications and fail to attend informational meetings. Executives would then wonder why letters and speeches to employees were not helping to alleviate concerns and communicate the organization's direction. This distrust was found to result from the organization's own actions (Walston and Kimberly, 1997).

Countermeasures to diminished trust include frequent and ongoing communication, involvement of workers in the design and evaluation of change initiatives, and other change management practices as described in the next section. Moreover, regardless of whether an HCO is undertaking a formal redesign or reengineering process, involving nurses in work decisions and providing them with control over caregiving practices by empowering them to make clinical decisions have been linked to greater levels of organizational trust (Laschinger et al., 2000). This observation is discussed in greater detail in the section below on work design and work flow decision making.

Poor Change Management

Very little documentation exists about how HCOs have implemented reengineering and restructuring initiatives. One well-designed study involved intensive interviews with 60 executives, 121 midlevel managers, 31 physicians, 24 staff nurses, and 19 non-nurse staff members at 14 hospitals that had undertaken reengineering initiatives in the past 5 years (Walston and Kimberly, 1997). The hospitals were selected in collaboration with a consulting firm specializing in hospital reengineering. Although the researchers acknowledge that selecting hospitals that used the same consulting firm may have created bias, they note that they took great care in choosing a sample of hospitals that varied by size, geographic location, and organizational affiliation and ownership. The findings of this study and a few others indicate that the change management practices identified in the previous section (i.e., ongoing communication; worker training; use of mechanisms for measurement, feedback, and redesign; sustained attention; and worker involvement) are not consistently observed in the reorganization, redesign, and reengineering initiatives undertaken by hospitals. Often these failures are intertwined.

Inadequate Communication

Walston and Kimberly (1997) found that although all redesign initiatives began with planned communication strategies that included special newsletters, employee meetings, forums, and one-to-one meetings between managers and employees, communication was either discontinued or not updated to provide feedback on the status of the project after its initial stages. As communication efforts declined, employees fell back into old routines. Thus, these poor communication practices also reflected a lack of sustained attention to the change initiative. Poor communication from administration to staff throughout reengineering initiatives has also been reported by nurses (Barry-Walker, 2000; Ingersoll et al., 2001) and other workers (Decker et al., 2001) involved in other individual hospital reengineering initiatives.

Insufficient Worker Training

Walston and Kimberly (1997) found that, as result of reengineering projects, staff nurses and individual unit nurse managers were frequently assigned greater managerial responsibilities without additional training. Nurses commented that excellent clinical nurses frequently lacked the management skills necessary to direct and delegate responsibilities to a subordinate team, and that delegation and managerial skills were not routinely taught. At the same time, senior management did not appear to recognize that many of the necessary managerial skills are cognitively learned competencies and should be addressed prior to the assignment of new responsibilities.

This finding is echoed by hospital nurse executives involved in reengineering initiatives who reported needing the following additional knowledge to help them meet the new expectations set for them by their HCO (Gelinas and Manthey, 1997):

  • Use of clinical pathways and other quality improvement tools to measure and manage outcomes
  • Understanding of managed care
  • Understanding of finance, including capitated environments and risk sharing
  • Team-building skills
  • Change management expertise

The need to train nurse managers in delegation and management skills, strategies for dealing with role change, and the economic and policy factors that contribute to changes has been documented in other studies as well (Ingersoll et al., 2001).

Walston and Kimberly (1997) also found that many hospitals that employed cross-training of non-nursing staff to perform patient care activities underestimated the amount of initial training and retraining that was needed. Researchers were told that often after initial, brief training periods (some as short as 3 days), new workers were assigned patient responsibilities, such as the performance of electrocardiograms and phlebotomies, only to function very inadequately. Much of the rework fell back on nursing staff. The researchers note that training costs are high when comprehensively addressed. One 500-bed hospital spent $700,000 on its training in the first 2 years of its reengineering initiative. This hospital also performed a gap analysis to identify those roles not being performed adequately and to evaluate what additional training was needed. The reviewers concluded that such continual evaluation of training needs is important to the effective implementation of new roles and responsibilities.

Lack of Measurement and Feedback

Walston and Kimberly (1997) observed a lack of measurement and feedback to staff on the progress of reengineering efforts. In many situations, feedback either was not provided at all or if provided, was not well understood. Both managers and employees frequently reported that they rarely heard about the results of reengineering efforts. Although every hospital developed some type of data tracking mechanism, employees typically either lacked access to the data or felt that the availability of the data was inadequate. This inability to record and display the progress of reengineering frequently caused a perception that the outcomes would not be sustained and resulted in diminished efforts to sustain the process.

Short-Lived Attention

Walston and Kimberly (1997:153) further found that effective organizational reengineering initiatives require long periods of time and constant effort. “Many hospitals that were two to three years into their engineering effort had yet to implement all of their initial plans. The most simplified plan of any of the hospitals demanded at least a year to analyze, plan, and implement.” During this time, employees expressed concern that the engineering initiative “drifted” and lacked consistency. The transition from initial implementation to sustained operation of the reengineered processes was most at risk. “Although many hospitals perceived reengineering to be a continual change process that would reorient their organizations, many facilities ended their efforts at least temporarily, after the initial implementation. Without continued and constant efforts, the organizations drifted back to the status quo. A mid-manager from a large teaching hospital reported, ‘The gains are now disappearing as people go back to their old ways of doing things'” (Walston and Kimberly, 1997:160).

Lack of sustained attention is, in part, a function of how an organization codifies a change through formal reporting structures, management tools, and policies and procedures. A 1996–1997 survey of CEOs of U.S. general medical–surgical hospitals located in urban areas and with more than 100 beds found that 40 percent of the 29.4 percent of responding CEOs had not formalized the change process through written manuals, guidelines, budgets, or some combination of the three (Walston et al., 2000).

Low Worker Involvement in Developing Change Initiatives

Walston and Kimberly (1997:157) also found a lack of uniform involvement by organizational departments in HCO reengineering efforts:

Most of the hospitals had a single individual that was the “champion” of reengineering. This was generally a top executive—the chief nursing officer, the chief executive officer, the chief financial officer, or an associate administrator…. At one hospital where the chief nursing officer was the key patron of engineering, each department was directed to develop cost reduction recommendations. Nursing developed a patient-focused plan to incorporate many services, including respiratory therapy, into nursing units, which was projected to save substantial costs. When they presented their plan to the hospital's steering committee for approval, they were informed that they could proceed with their recommendation except for the respiratory therapy component. Respiratory therapy had previously obtained approval from the steering committee without nursing's knowledge for its own plan that called for laying off a number of part-time respiratory therapists, providing a fixed number of inpatient therapists, ranking all patients according to the severity of their need for respiratory therapy, and providing care to only the sickest patients as far as the fixed hours would allow. Nursing was both astonished and angry, for respiratory therapy was allowed to exempt itself from a coordinated reengineering process and its solution would pass a great amount of work back to nursing services. Variations of this problem occurred in many other hospitals causing inconsistent participation and ineffective implementation.

In addition, limited involvement of nurses (Barry-Walker, 2000) and other health care workers (Decker et al., 2001) has been reported in studies of individual HCO reengineering efforts.

Limited Involvement in Decision Making Pertaining to Work Design and Work Flow

The involvement of nurses in decision making has varied over time and by the hierarchical level of the nurse within the HCO. In the 1970s and 1980s, under the primary care model of nursing practice, hospital nurses had responsibility for clinical nursing care decisions for assigned patients for the patients' entire hospital stay (see also Chapter 3 ). Moreover, as a result of some of the health care integration and reengineering initiatives of the 1980s and 1990s, nurses in charge of an 8-hour shift (often called shift “charge nurses”) were elevated to the position of “nurse managers” who functioned—with responsibility 24 hours a day, 7 days a week—as the head of a nursing unit. These nurse managers often were made responsible for hiring personnel, allocating resources, evaluating performance, setting standards of practice, and disciplining staff who did not meet standards or competency expectations (Norrish and Rundall, 2001). This shift in responsibilities coincided with the promotion of “shared-governance” models of nursing practice that promised increased participation of nursing staff and management in operational and policy decision making. As described previously, however, descriptions of shared governance have shown wide variation in the specific decisions made or shared by nurses and managers, which staff are included in the shared-governance decision making, and whether nurses have authority for decisions individually or collectively. Thus, models of shared governance have ranged from minimal, ad hoc, informal participation by some nursing staff in a limited number of decisions to models in which the authority and accountability of professional nurses are codified within the organization, and formal decision-making structures and processes are in place that enable nurses to define and regulate nursing practice and share decisions with administrators regarding the management of resources (Maas and Specht, 2001).

Shared-governance practices waned in the 1990s as reengineering and integration initiatives modified the roles of nursing staff and management. The above-cited study of changes in the work environments of nurses in 12 hospitals identified as having characteristics associated with high rates of nurse retention found that from 1986 to 1998, the percentage of nurses reporting “the freedom to make important patient care and work decisions” declined from 98 to 80 percent (Aiken et al., 2000:463). In a 1998–1999 survey of nurses working in acute care hospitals in Pennsylvania, only 29 percent reported that their administration listened and responded to nurse concerns; 40.6 percent reported that nurses had the opportunity to participate in policy decisions; and 60.5 percent reported being able to participate in developing their own schedules (Aiken et al., 2001).

Limited Knowledge Management

As discussed earlier, learning organizations take advantage of all sources of knowledge, use systematic experimentation to generate new knowledge internally, and transfer knowledge quickly and efficiently throughout the organization. The little available evidence on knowledge management as practiced in nurses' work environments indicates very limited use of these practices. A search for “knowledge management” or “learning organization” in the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for English-language publications, with no date limitations, yielded but a few articles. These articles are primarily exhortations for the adoption of knowledge management and learning organization practices, as opposed to descriptions of their application. This may be in part because these practices are catalogued under different labels, such as “decision support,” “informatics,” “continuous quality improvement,” or “total quality management.” Also, the use of knowledge management and learning organization principles does not apply solely to nursing, but to all health care providers, so it may not be described as a “nursing” practice. However, a similar MEDLINE search for the years 1971–2003 returned only 24 articles with these topics in the title.

Knowledge is available from multiple sources: from internal HCO sources such as total quality management, risk management, and patient and provider experiences with care delivery, as well as from external sources such as research, the professional literature, technology assessment reports, and authoritative practice guidelines. According to Donaldson and Rutledge (1998:6), however, organizational translation of new knowledge from external sources into language and operations familiar to potential users has been “largely ignored in nursing literature.” Six large-scale multifaceted studies of the diffusion and utilization of nursing research undertaken over the past two decades have documented the need to build knowledge utilization infrastructures, expand the capacity of individual nurses to take up new knowledge, and expedite the transmission of new knowledge from external sources to nurses (Donaldson and Rutledge, 1998).

There is also evidence that HCOs do not learn well from internal sources of information. A Harvard Business School study of hospital nurses, their errors, and the extent to which they actively seek to prevent future occurrences of similar errors found that hospitals are not learning from the daily problems and errors encountered by their workers (Tucker and Edmondson, 2003). Twenty-six nurses at nine hospitals were observed for 239 hours, and interviews were conducted with 12 of the nurses at seven sites. Researchers purposely selected hospitals with a reputation for nursing excellence by asking nursing governing boards for referrals to such hospitals and by searching the nursing literature on magnet hospitals. Their goal was not to employ a representative sample of hospitals, but to assess how excellent nursing hospitals handle service failures. From these observations, common basic patterns of problem-solving behavior across the nine hospitals were identified.

Researchers distinguished two types of process failures: “errors” and “problems.” “Errors” were defined as the execution of a task that was either unnecessary or carried out incorrectly. “Problems” were defined as disruptions of the nurse's ability to execute a prescribed task because a resource was unavailable at the needed time, location, or condition or in sufficient quantity (e.g., missing supplies, information, or medications), thus preventing the task from being implemented.

Of the 194 observed failures, 86 percent were problems rather than errors. This finding is significant to improving patient care for several reasons. Problems are relatively frequent and visible, and also carry fewer stigmas than errors; all of these features facilitate an HCO's taking action on a problem to improve patient care and safety. However, researchers found that nurses tended to practice “first-order” problem solving, that is, fixing the immediate problem without communicating that it occurred, investigating why it occurred, or seeking to change its cause. Thus the problem was isolated so that it did not become visible to the hospital as an opportunity to learn how to be more efficient or effective in patient care. Second-order problem solving, in contrast, occurs when a worker, in addition to fixing the problem so the task at hand can be completed, takes action to address the underlying cause. Researchers used lenient criteria—i.e., encompassing any behavior that called attention to the problem—to assess the extent to which second-order problem solving had occurred. Nonetheless, only 7 percent of nurse responses were second-order.

Researchers identified three human resource practices that explained why so few problems had received second-order attention that would have enabled the organization to learn from the problems and correct systemic weaknesses. First, instilling in nurses a strong sense of responsibility for individual vigilance can, as a side effect, encourage such a strong emphasis on independence and self-sufficiency that they see a failure not as a system problem, but as one that can be overcome or withstood through individual competence. The majority of the nurses interviewed commented that they believed their manager expected them to work through daily disruptions on their own. Speaking up about a problem or asking for help was likely to be viewed as a sign of incompetence. Second, staffing levels were so tight, with so little slack in the system, that nurses did not have the time to eliminate underlying causes of problems. Instead, they were “barely able to keep up with the required responsibilities and [were] in essence forced to quickly patch problems so they [could] complete their immediate responsibilities” (Tucker and Edmondson, 2003:9). Finally, removal of front-line managers and other personnel not involved in direct patient care from daily work activities left workers on their own to resolve problems. At hospitals characterized by second-order problem solving, either nurse managers were a strong presence on the floor, or there was a designated person available to provide guidance and support to nurses (Tucker and Edmondson, 2002). The researchers concluded that “reducing the degree to which managers are available to front-line staff can be a loss for improvement efforts, especially when workers are already overburdened by existing duties” (Tucker and Edmondson, 2003:10).

The researchers identified several countermeasures to first-order problem solving to enable organizational learning. First, managers must be available to staff nurses for at least a portion of all shifts. The researchers observed that the presence of managers increased the likelihood of their being informed of problems occurring on the unit, thus enabling them to investigate and intervene with systemic solutions. Managers also serve as role models for system-level thinking, encouraging nurses to think of second-order solutions. Second, management needs to create a “fair and just” work environment (discussed in Chapter 7 ) that encourages workers to feel secure in reporting both errors and problems so system performance can be enhanced (Tucker and Edmondson, 2003). Also, if workers are to engage in identification and elimination of systemic problems, this activity should be an explicit part of their job description (Tucker et al., 2002), and they should receive training in its application (Tucker and Edmondson, 2002). Finally, management needs to act on reported problems with second-order solutions so workers will have an incentive to continue to identify these opportunities for learning and improvement (Tucker and Edmondson, 2003).

Recommendations to Promote Evidence-Based Management Practices

To address the deficiencies discussed above in nurses' work environments with respect to the application of the five management practices introduced in this chapter, the committee offers the following two recommendations:

Recommendation 4-2. Leaders of HCOs should take action to identify and minimize the potential adverse effects of their decisions on patient safety by:

  • Educating board members and senior, midlevel, and line managers about the link between management practices and safety.
  • Emphasizing safety to the same extent as productivity and financial goals in internal management planning and reports, and public reports to stakeholders.

Recommendation 4-3. HCOs should employ management structures and processes throughout the organization that:

  • Provide ongoing vigilance in balancing efficiency and safety.
  • Demonstrate trust in workers and promote trust by workers.
  • Actively manage the process of change.
  • Engage workers in nonhierarchical decision making and in the design of work processes and work flow.
  • Establish the organization as a “learning organization.”

These recommendations are feasible. Indeed, they are currently practiced in a number of nursing work environments described in the next section.

  • MODELS OF EVIDENCE-BASED MANAGEMENT IN NURSES' WORK ENVIRONMENTS

The five evidence-based management practices described above have been employed successfully in a number of nurse work environments by HCOs acting alone or in collaboration with one another. Examples include magnet hospitals, the Pittsburgh Regional Healthcare Initiative, and the Wellspring model of long-term care.

Magnet Hospitals

In the early 1980s, during one of the cyclical nursing shortages, a task force of the American Academy of Nursing undertook a study to identify those hospitals—labeled “magnet hospitals” that had no difficulty in attracting and retaining nurses during such shortages (McClure et al., 1983). Through two decades of research, the characteristics of these magnet hospitals have been articulated and their relationship to nurse and patient outcomes studied.

In the original magnet hospital study, 165 organizations were identified across the country that fit three criteria: (1) nurses saw the hospital as a good place to work; (2) the hospital was able to recruit and retain nurses (as measured by a lower-than-usual turnover rate during a nursing shortage situation); and (3) the hospital was located in a market area that included other hospitals competing for its nurses. Based on a review of the hospitals' recruitment and retention records as well as other material, 41 organizations were selected as magnet hospitals (McClure et al., 2002). Systematic interviews with the CNE and a selected staff nurse from each organization provided the data for an analysis of the characteristics that attracted and retained nurses in these hospitals. Magnet characteristics were identified in the areas of administration, professional practice, and professional development. Many of the leadership and management practices cited previously (providing strong leadership, managing change, creating and sustaining trust throughout the organization, involving workers in decision making pertaining to work design and work flow, and establishing the organization as a learning organization) have been documented as present in magnet hospitals. 4

In a series of six surveys between 1985 and 2001, Kramer and Schmalenberg refined the original set of magnet characteristics. Their studies included a subset of 16 of the original magnet hospitals, selected by geographic location. The surveys involved interviews of CNEs, staff nurses, nurse managers, and clinical experts (Kramer, 1990a,b; Kramer and Schmalenberg, 1988a,b, 1991, 1993; Kramer et al., 1989). In these surveys, eight essential characteristics associated with magnetism were again identified by two-thirds or more of the staff nurses interviewed. They included working with clinically competent nurses (an essential element of trust), nurse autonomy and accountability, having a supportive nurse manager/supervisor (a component of both leadership and trust), control over nursing practice, and educational support (Kramer and Schmalenberg, 2002).

Two studies have examined patient mortality rates in relation to magnet hospital status. In the late 1980s, 39 magnet hospitals were compared with 195 nonmagnet matched hospitals using Medicare mortality rates. Adjusting for differences in predicted mortality for Medicare patients, the magnet hospitals had a 4.6 percent lower mortality rate, which translates to 0.9 to 9.4 fewer deaths per 1,000 discharges (Aiken et al., 1994). In a second study, patients with AIDS in magnet hospitals and those with AIDS in nonmagnet hospitals with and without designated AIDS units were compared. Patients in the magnet hospitals had a lower chance of dying than those in the nonmagnet hospitals regardless of the existence of designated AIDS units (Aiken et al., 1999). In the early 1990s, the American Nurses' Association, through the American Nurses' Credentialing Center (ANCC), established a formal certification program through which hospitals and nursing homes may apply for “magnet status.” The criteria for selection are based on the characteristics originally identified, as well as on specific standards of practice and administration.

In the above studies, the major administrative determinant of magnetism was found to be the quality of leadership from the CNE (Kramer and Schmalenberg, 1988a,b; McClure et al., 2002). This individual was visible in the organization, took part in policy-level decision making, and set the stage for a decentralized organizational structure and participative management. His/her leadership style conveyed respect for the staff nurses and trust in their ability to provide high-quality patient care. In Kramer and Schmalenberg's 1989–1990 study comparing magnet and nonmagnet hospital nurses' perceptions of leadership–management values, staff nurses at magnet hospitals gave significantly more positive responses (p > 0.001) on such items as “Our nursing leaders are visionary, and they communicate and implement ideas, values and goals”; “Potential problems are anticipated and worked on before they become problems”; and “With stable expectations of what must be done to achieve goals, people here are free to experiment and try new things” (Kramer and Schmalenberg, 2002).

Presence of Trust

The presence of trust in the work environment of magnet hospitals was found to be facilitated by the nursing leadership, as discussed above, and also by strong clinical competence among nursing colleagues. Competence was revealed as one of the most essential characteristics of trust, as described earlier in this chapter. Indeed, the clinical competence of nurse colleagues has been identified consistently by staff nurses as a feature of magnet hospitals since 1986, when Kramer and Schmalenberg's first study surveyed 1,634 staff nurses in 16 of the originally designated magnet hospitals (Kramer and Schmalenberg, 1988a,b). Kramer and Hafner (1989), for example, report that working with clinically competent nurses was associated with positive relationships among coworkers, low turnover, effective nursing, and job retention. The investigators quote staff nurses as saying they could work with fewer staff if they had clinically competent nurses they knew and could trust.

Involving Workers in Decision Making

Autonomy and control over nursing practice recurrently have been identified as strong characteristics possessed by staff nurses, nurse managers, and CNEs in magnet hospitals (Aiken, 2002; Kramer and Schmalenberg, 2002; McClure et al., 1983; Scott et al., 1999). As discussed earlier, a distinction is made between autonomy and control over nursing practice. Autonomy refers to nurses' control over their work, that is, their ability to make independent clinical decisions and define the scope of practice in relationship to patients in their care (Kramer and Schmalenberg, 2002; McClure et al., 1983; Scott et al., 1999). Control over nursing practice is an organizational level of autonomy, in which staff nurses, nurse managers, and CNEs participate in all levels of hospital policy decisions about professional practice and patient care (Kramer and Schmalenberg, 2002; Scott et al., 1999). Magnet hospitals score higher on greater autonomy for nurses to act and greater nurse control over resources for patient care (Aiken et al., 1997).

A series of studies comparing the hospitals identified as having magnet characteristics in 1983 (the original magnet hospitals) with hospitals that subsequently received that designation from the ANCC found that the latter hospitals had significantly higher levels of nurse autonomy and control over practice. Staff nurses perceived the ANCC magnet hospitals as having greater resources available for patient care; increased time to discuss patient problems with other colleagues; greater involvement in decision making; and strong, visionary CNEs. Stronger magnet characteristics were also evident in the ANCC magnet hospitals when CNEs were interviewed. CNEs in ANCC magnet hospitals (n = 24) viewed autonomy and control over nursing practice as stronger than did CNEs in the original magnet hospitals (n = 24). Three differences among the hospitals were identified as explaining the higher rating of the ANCC hospitals: the latter hospitals had a department of nursing to which nurses were responsible; they were more apt to have a nurse-researcher providing data for decision making; and they regarded nursing as a distinct profession, making a highly valued contribution (Havens, 2001).

Knowledge Management

Professional development, including teaching students, is consistently cited as an important magnet characteristic in terms of continued learning and career development through formal and informal methods. In the original magnet hospital study (McClure et al., 1983), an essential characteristic identified was professional development, including continuing educational opportunities and support for career development through formal education. A high proportion (92.7 percent) of the directors of nursing held masters or doctoral degrees. In Kramer and Schmalenberg's 1986 study of a subset of the magnet hospitals, a median of 51 percent of the staff nurses had a BSN or had matriculated in BSN study, compared with a national average of 33–34 percent (Kramer and Schmalenberg, 1988a,b).

This magnet characteristic was identified more recently by Kramer and Schmalenberg as one of the most essential features of magnetism cited by staff nurses. Magnet hospitals use a number of strategies to provide support for education and continuing career development for staff nurses, such as tuition for degree programs, in-service programs, short-term courses, externships for student nurses, and internships for new graduates (Kramer and Schmalenberg, 2002).

Pittsburgh Regional Healthcare Initiative

The Pittsburgh Regional Healthcare Initiative (PRHI) is a coalition, begun in 2000, of 35 hospitals; four major insurers; more than 30 major and small-business health care purchasers; numerous corporate and civic leaders; organized labor; state and federal governments; and academic and research institutions, including Carnegie Mellon University, RAND Corporation, the University of Pittsburgh Center for Health Services Research, and Purdue University (Feinstein, 2002). PRHI adapted the principles of the Toyota Production System and implemented practices to manage change, involve workers in decision making about work design and work flow, and become a learning organization to achieve the goal of “perfecting patient care” (Feinstein et al., 2002). PRHI participants have as their goal “delivering patient care on demand, defect free, one by one, immediately, without waste or error, in an environment that is physically, emotionally, and professionally safe” (The Jewish Healthcare Foundation of Pittsburgh, 2002:12).

PRHI is spearheaded by a “leadership obligation group” comprising hospital and other corporate CEOs charged with keeping the initiative moving forward (Robinet, 2002). It focused initially on two patient safety goals: eliminating medication errors and hospital-acquired infections (Feinstein et al., 2002). Multidisciplinary advisory committees at each PRHI partner facility adopted and use the same incident-reporting system for hospital-acquired infections and medication errors. In a partnership with the U.S. Centers for Disease Control and Prevention (CDC), PRHI hospitals developed a common reporting tool based on CDC's national Nosocomial Infection Surveillance System—the oldest and most widely used surveillance system for hospital-acquired infections—and a similar standardized web-based error-reporting tool for medication errors. PRHI hospitals share their data with each other, as well as nationally. The data are translated into knowledge that front-line health care workers can use to protect patients (Feinstein, 2002).

PRHI collects data from all participating hospitals, maps them to patient outcomes, and correlates them with processes of care. Based on those findings, its members institute experimental changes in work design to improve patient safety. In this way, PRHI carries out the practice of becoming a learning organization. Groups of people actually performing the work determine the root cause of a problem, experiment with ways to solve the problem using scientific methods, and then measure the results and share what has been learned (Feinstein et al., 2002). PRHI partners empower health care workers to address problems. When a problem is detected, a team of workers designs a solution immediately, employing a set of predesigned principles and scientific methods. Every worker is expected to become a scientist and to contribute to rapid, frequent improvements. PRHI also includes a Center for Shared Learning that coordinates all PRHI improvement efforts.

The Wellspring Alliance

Wellspring Innovative Solutions, Inc. (Wellspring) is a federation of 11 freestanding not-for-profit nursing homes in eastern Wisconsin. Fully operational since 1998, its two-fold purpose is to improve the clinical care provided to residents and to create a better work environment for employees. A 15-month evaluation of the Wellspring model found:

  • Better patient surveillance by staff.
  • Improved performance as measured by federal oversight surveyors.
  • Better quality of life for patients and improved quality of staff–resident interactions.
  • Lower staff turnover relative to comparable nursing homes in Wisconsin for the same time period.

In achieving these benefits, Wellspring has attended to the leadership of these organizations, trusted workers to make decisions about improvements to patient care, created structures and processes to sustain these changes, and instituted practices aimed at supporting members as learning organizations.

Leadership and management support is provided by a formal organizing superstructure (The Wellspring Alliance) that, in addition to carrying out several practical functions, such as joint purchasing, provides a forum for collaborative information sharing, education and training, and knowledge dissemination across the facilities. The Alliance functions on many levels, including CEOs; administrators; line staff; and a designated Wellspring coordinator in each facility, whom evaluators identified as arguably the single most important contributor to the successful implementation and sustained operation of the Wellspring model. Coordinators serve as both a formal link between the facility and the Alliance and an informal conduit of information across facilities. These individuals meet and interact at quarterly meetings and training events and help codify lessons learned.

Employee education and training are facilitated by a geriatric nurse practitioner who serves as a primary resource on clinical care, develops staff training modules, provides centralized clinical education and training to staff, and travels to member facilities on a quarterly basis to provide feedback to the facility and reinforce and sustain the adoption of the clinical practices taught in the various modules. Training is cross-disciplinary and targeted to employees as team members. Team members learn collaborative problem solving and share responsibility for resident outcomes. Wellspring uses this team training as a way of decreasing the hierarchical relationships that are typical in nursing home staff relationships.

Care resource teams are described as the “main engine” of the patient care improvement activities undertaken by the facilities. These teams are interdisciplinary, nonhierarchical (e.g., nursing assistants may lead a team), voluntary, and self-directing. Teams are expected to identify and develop new work strategies, monitor implementation success, and intervene when problems in implementation arise.

The Wellspring Alliance fosters the evolution of all its member facilities into learning organizations through several practices. One is the sharing of the geriatric nurse practitioner and the facility coordinators to disseminate and nurture the adoption of evidence-based best practices in the care of residents. Another strategy being pursued is having each member facility enter data (e.g., number of incontinent episodes, falls, and weight loss) into a common data set on a quarterly basis (although evaluators found this aspect of the Wellspring model to be most problematic and least well implemented). A data analyst aggregates the data, prepares analytic reports, and presents these reports at quarterly meetings. This practice facilitates the systematic transfer of knowledge across facilities and nursing units, through the clinical resource teams, to staff, and the application of that knowledge is sustained through regularly scheduled care resource team meetings in the facility (Stone et al., 2002).

  • USE OF EVIDENCE-BASED MANAGEMENT COLLABORATIVES TO STIMULATE FURTHER UPTAKE

The PRHI and Wellspring models described above are examples of learning collaboratives in which resources, knowledge, and experiential learning are shared to improve clinical practice. Collaborative approaches have also been used as mechanisms to facilitate the uptake of health care quality improvement practices (Institute for Healthcare Improvement, undated), technology assessment and dissemination (The Health Technology Center [HealthTech], 2003), and strategic marketplace assistance for HCOs (VHA, 2003).

Evidence-based management collaboratives (EBMCs) have been proposed as a means of bringing together managers, consultants, and researchers to improve health care management and thereby organizational performance (Kovner et al., 2000). These collaboratives would consist of a team of managers, researchers, and consultants from a variety of organizations whose aim would be to better understand problems in effective health care management and to develop more effective approaches to managing health systems. EBMCs would provide access to data and partners within an organization's network to permit pooling of data and resources for the conduct of research, demonstrations, and evaluations that no single organization could undertake. Estimates are that just 10 percent of the annual consulting budget for a large health system redirected to such a collaborative would be sufficient to finance this capacity. EBMCs could be implemented across several different health systems, in one health system, or both. Organizing across systems that are in competition in specific markets has been identified as difficult; thus, organizing noncompeting organizations and their existing alliances has been proposed as an initial approach.

EBMCs would require (1) a strong commitment to improving health care management through the application of evidence, (2) a willingness to use and share management data from compatible management information systems to track and monitor strategic interventions and organizational performance, (3) an interest in participating in applied research, and (4) an interest in being involved in demonstration projects to improve health system performance. In return, collaborative partners would receive comparative information on current ways of organizing services; access to the collective experiences of other cooperative members; results from applied research projects; and an array of technical assistance on statistical, management, and marketing issues (Kovner et al., 2000).

A critical partner in these endeavors would be a research center, typically university-based, with an interest and capacity in applied research on health systems and performance, strategic initiatives, and related management and financial issues. The academic partner could provide expertise in data analysis, survey design, program evaluation, and professional education. In addition to serving its collaborative members, the EBMC could assist in disseminating its findings to a broader community of HCOs through peer-reviewed journals, and in training new evidence-based managers and health services researchers (Kovner et al., 2000).

The prototype EBMC is the Center for Health Management Research (CHMR), led by the University of Washington and codirected by the University of California at Berkeley. CHMR was founded in 1992 by a consortium of HCOs and academic centers to provide a forum for managers, clinicians, and researchers to:

  • Develop a health care management research agenda in collaboration with corporate members.
  • Undertake research, development, and evaluation projects in pursuit of that agenda.
  • Disseminate research findings and successful management practices of other HCOs and other industries to its members.

Now involving 17 academic centers with graduate programs in health services administration (personal communication, T. Rundall, University of California, Berkeley, May 2003), CHMR is sponsored by the National Science Foundation (NSF) under its Industry/University Collaborative Research Centers program. It is the only one of the 50 NSF Collaborative Research Centers to receive this designation for the field of health services administration (Center for Health Management Research, 2003). CHMR is also supported by its 10 member health systems, which provide financial resources, collaborate on setting research priorities, and allow researchers to collect data at their various facilities. These members are thereby able to develop and implement a research agenda focused on their defined interests and needs. By serving as the primary sites for CHMR research, member institutions also are able to develop, test, and evaluate management practices, as well as other innovations and new technologies. CHMR practices are disseminated to entities not part of the collaboration through published reports and journal papers. Studies are designed with the transferability of research findings in mind. Other activities include commissioning papers to review and synthesize research findings on selected topics, conducting roundtable discussions on management topics, and holding dissemination conferences where members receive oral and written presentations from researchers (Walshe and Rundall, 2001).

CHMR has undertaken a wide range of research projects to enable evidence-based managerial decision making in its member health systems. By design, its corporate members are integrated delivery systems, and the overarching theme of its research projects has been the strategies, structures, processes, and performance of such systems. One recent research project addressed mechanisms for building more effective relationships between the HCO members and physicians (Walshe and Rundall, 2001). Similar initiatives could address the work environments of nurses and patient safety.

The committee concludes that broader use of such collaboratives could hasten the uptake of the evidence-based management practices described in this chapter, and therefore makes the following recommendation:

Recommendation 4-4. Professional associations, philanthropic organizations, and other organizational leaders within the health care industry should sponsor collaboratives that incorporate multiple academic and other research-based organizations to support HCOs in the identification and adoption of evidence-based management practices.

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The human resource side of change tends to be undermanaged as compared with management of the implementation of technological changes (Kimberly and Quinn, 1984).

Unlike the title of CEO or chief financial officer (CFO), the title of CNO is not used consistently across HCOs, nor is it always accompanied by executive-level functioning. The CNO designation can be found at all levels of an HCO (Clifford, 1998).

For ease of reference, the committee's recommendations are numbered according to the chapter of the main text in which they appear.

The studies of magnet hospitals have also identified other important practices, such as maintaining adequate staffing levels and professional nurse–physician relationships. These other characteristics of magnet hospitals are discussed in the relevant chapters of this report.

  • Cite this Page Institute of Medicine (US) Committee on the Work Environment for Nurses and Patient Safety; Page A, editor. Keeping Patients Safe: Transforming the Work Environment of Nurses. Washington (DC): National Academies Press (US); 2004. 4, Transformational Leadership and Evidence-Based Management.
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  • Steve Jobs’ Leadership Style: Essay Example The paper studies the leadership style and traits of Steve Jobs and presents evidence that characterizes the leadership as transformational and charismatic.
  • Social Sciences: A World Without Leadership This paper will analyze a world that is, in fact, void of leadership and affirm that leaders are the driving force behind every prosperous civilization.
  • Leadership Styles Used by the Church There are many different styles of stewardship that a leader can adopt in controlling church activities: autocratic, despotic, democratic, Laissez-Faire rules, etc.
  • Nelson Mandela: Researching of Leadership Nelson Mandela was a unique political leader who, without aggression, was able to build trusting relationships not only with the people of his country but also with other countries.
  • The Concepts of Leadership and Management This report will examine the link between leadership and management, introduce theoretical behavioural approaches to leadership development.
  • Management and Leadership in the Hospitality Industry This paper aims to evaluate the validity of leveraging competencies of leadership and management in an attempt to achieve competitive advantage.
  • The Leadership Theories: Pros and Cons The situational leadership theory, the path-goal theory, and the five-factor personality models might illustrate a leader’s role as a set of skills that can be acquired.
  • Nursing Leadership and Management This essay explores the similarities and differences between leadership and management in nursing. It focuses on how nurse leaders and managers perceive quality improvement.
  • The Impact of Apostle Paul Leadership Style Apostle Paul is the most important figure after the death of Jesus. He employed a transformational leadership approach to motivate his followers to change.
  • Leadership and Management in Early Childhood Education The paper examines why leadership and management are confused among early childhood education professionals. One can easily understand both terms.
  • Leadership Styles in Government Institutions This research paper digs deeper in order to understand the issues and leadership styles implemented in government institutions.
  • Emirates Airline: Leadership Styles and Performance The study investigated the influence of four leadership styles on the organizational performance of Emirates Airline from the perspective of communication.
  • Psychodynamic Approach to Leadership Development The psychodynamic approach to leadership is a philosophy of human behavior that focuses on reasons or forces that drive individualistic societal attributes.
  • Proposal for New Leadership Training Before implementing change within an organization, it is important for management team to acquire effective leadership training.
  • Leadership in Health Care: Situational Leadership Theory The paper discusses the leadership issues in health care. It demonstrates that the particularities of emergency care units necessitate a flexible approach to leadership.
  • Marissa Mayer’s Leadership Style at Yahoo! Successful leadership entails identifying the specific demands of an organization and actions to address issues. The paper highlights Marissa Mayer’s leadership style.
  • Examples of Ethical and Unethical Leadership in History One of the most relevant areas in modern social sciences has become theoretical and practical research into the phenomenon of leadership.
  • Contingency and Situational Theory in Leadership This essay focuses on contingency theory and situational theory in leadership, compares these theories, mentions the importance of various factors affecting leadership.
  • Leadership Styles in “Apollo 13” by Ron Howard In Apollo 13 directed by Ron Howard, it is possible to observe several types of leadership that are mostly represented by such characters as Jim Lovell and Gene Kranz.
  • Change-Oriented Leadership: Transformational and Charismatic Leaders Travis Kalanick is a founder and CEO of Uber, which is considered one of the most successful startups in the recent times. Many have criticized his leadership style.
  • Trait Approach and Skills Approach to Leadership Leaders play critical roles that set new directions and visionary performance ideals within institutions. Leaders improve effectiveness and competence during service delivery.
  • Woolworths’ Integrated Cost Leadership/Differentiation Strategy An Integrated Cost Leadership/Differentiation strategy has ensured that Woolworths deter other competitors from gaining access to the market and its market shares.
  • Statesmanship Model and Organizational Leadership Statesmanship remains relevant in modern organizational leadership and communication, perhaps even more relevant than ever before.
  • Leadership Approaches During the COVID-19 Pandemic As the COVID-19 pandemic continues, leaders need to act in an environment of unpredictability and incomplete information.
  • Howard Schultz’s Servant Leadership at Starbucks Howard Schultz’s managerial style at Starbucks is admired and analyzed by many scholars. As the C.E.O., he applied servant leadership efficiently in order to empower his followers.
  • Self-Leadership and Management The paper provides a detailed assessment of management strengths and weaknesses, the strategies to build leadership capabilities, and the approach used to inspire followership.
  • The Role of Leader and Leadership in the Organization In an organization, success and failure are dependent on the manager, and the manager’s success and failure are based on his leadership qualities.
  • Leadership in the 21st Century Leaders must have professional skills in scheduling, time management, allocation of resources, and delegating responsibilities among their auxiliaries.
  • Leadership at the Workplace This paper will focus upon the different leadership behaviors and the best leadership behavior which should be adopted to meet the company’s goals.
  • Sony Corporation’s Leadership and Effectiveness One of the world’s leading manufacturers for the consumer and business industries in audio, video, communications, and information technology is Sony Corporation.
  • Leadership Challenges and How to Overcome Them This paper focuses upon the most difficult challenges which the leaders have to face to be called successful leaders and how successful leaders face those challenges.
  • Leadership and Management in Criminal Justice Understanding why leadership and management are helpful in the judiciary and law enforcement will go a long way to streamlining the criminal offices.
  • Importance of Leadership in Business In an organization that leadership is accepted as part of management principle, workers show a positive mind-set hence increasing the level of performance.
  • Amazon Company: Organization and Leadership With electronic performance monitoring, a company like Amazon can supervise and analyze an employee’s activities in real-time.
  • Poor Leadership Decision: A Case Study Leadership is a complex position associated with the necessity to make difficult decisions that will directly affect the performance of the unity.
  • Leadership Styles and Examples Throughout History This paper analyzes the leadership styles of famous leaders throughout history: Emperor Hirohito, George Washington, Lance Armstrong, Mother Teresa, and Bill Gates.
  • Strategic Leadership Course Reflection One can improve their leadership capabilities through training and development, which is how I plan on contributing to the well-being of my organisation.
  • Application of Leadership Theory Effective leadership is essential for a successful organization. However, it is not a simple role to fulfill, and it can involve a lot of different situations, goals, and interactions.
  • Transformational Leadership and Theory Y in Nursing Leadership refers to the use of skills, knowledge, and character traits of an individual with the goal of achieving mutually negotiated outcomes.
  • Microsoft and Apple, Inc.: Leadership Styles Microsoft and Apple had differences in leadership approaches in the past, yet they have adopted a transformational style due to its impact on a firm’s capabilities.
  • The Role of Time Management in Leadership Modern leaders pay much attention to time management as it is one of the constant and irreversible things in the work of any organization.
  • Mark Zuckerberg’s Leadership Strategies Mark Zuckerberg is one of the most successful leaders despite the criticisms presented by many stakeholders against him.
  • The Everyday Leadership TED Talk by Drew Dudley Leadership is an exceptionally crucial ability in all areas of life. Leaders influence others and can shape the direction of the development of their organization.
  • Leadership Styles: The Example of Bill Gates and Steve Jobs Through a specific pattern the leader can achieve job satisfaction among workers and increase their productivity.
  • Team Effectiveness Leadership Model Various issues could be addressed by the team effectiveness leadership model in which the leader should dedicate his efforts.
  • Leadership Theories and Examples Leadership theories are schools of thought brought forward to explain how and why certain individuals become leaders.
  • Nursing Leadership and Management: Quantum Leadership The quantum approach is essential in the management of complex situations that are experienced in contemporary work situations.
  • The Followership and Servant Leadership Comparison Followership and servant leadership have a wide range of similarities and differences based on interaction principles and appealing to certain elements.
  • Leadership and Change Portfolio: Ooredoo Ooredoo, a Qatari multinational telecommunication company, was founded in 1987 as a telephone exchange company and is today one of the largest communication operators.
  • Jeff Immelt’s and Jack Welch’s Leadership at General Electric This paper will analyze the core competencies and capabilities of General Electric, and outline the differences in management styles of Jeff Immelt and Jack Welch.
  • Starbucks’ Culture and Howard Schultz’s Leadership Success at Starbucks Corporation is directly attributed to the efficient communication and practical leadership.
  • Jack Welch’s Transformational Leadership Analysis Jack Welch is an example of a transformational leader. As a leader, he is known as an inspiring motivator and intellectual stimulator.
  • Leadership and Influence Process Only leaded by the right person, a group of people can become a closely-knit team. Surely, a leader should behave in a particular way.
  • Richard Branson’s Organic Leadership Richard Branson has demonstrated that organizations can influence the commitment of their employees through the development of an organic organizational structure.
  • True Leadership in the Invictus Film This paper discusses the role of true leadership as depicted in the film Invictus by focusing on the two main characters – Mandela and Pienaar.
  • “Leadership and the New Science” by M. Wheatley Today, research on the phenomenon of leadership is becoming more and more critical. This topic is particularly relevant for the development of effective methods of administration.
  • Leadership Style and Performance in UK Restaurants This research paper explores leadership behavior orientations within the restaurant sector in the UK in terms of their relationship to employee motivation.
  • Personal Leadership Development Plan Managerial leaders drive an organization with the kind of decision they make; the quality of decision creates a competitive advantage to a firm.
  • Trends and Issues in Nursing: Leadership and Management The health sector is one of the most important sectors in any society. Through proper management and leadership of nurses, reliable services will be delivered.
  • Leadership and Conflict Management The primary goal of the following paper is to present a practical way to employ conflict management skills within a team.
  • Nursing Leadership and the System of Christian Values Effective healthcare is partially built on the notion of leadership and management in nursing as it is one of its most extensive domains.
  • Leadership Trait Questionnaire and Reflection The trait approach to leadership suggests that a good leader has traits that help them to influence the team as well as provide effective results.
  • Situational Leadership Model: Strengths and Weaknesses This paper examines the situational leadership model, revealing its strengths and possible weaknesses, and shows how it works in practice by investigating particular case studies.
  • Authentic Leadership in Early Childhood Teaching The context of early childhood education (ECE) has been challenged by the fact that many leaders within the sphere have been unlikely to engage in formal leadership preparation.
  • Effective Leadership: The Biblical Perspective Effective leadership from a biblical perspective is a God manifested character to influence and serve others through Christ’s interests to accomplish God’s purposes.
  • Mary Teresa Barra’s Transformational Leadership The case of Mary Teresa Barra, CEO of General Motors, is an interesting example of how transformational leadership can result in improved organisational performance.
  • Leadership in the Hospitality Sector Leadership in the hospitality sector has very few distinctive features that make it any different from leadership in any other domain.
  • Leadership Development Plan Based on the Bible Principles Developed leadership skills can inspire further engagement from the staff, and Biblical principles of Leadership are intertwined to bring out one perfect guide.
  • Leadership Development in the US Army The following essay discusses the concept of leadership development, its importance in the US army, and further research.
  • Leadership and Management: Case Study Analysis In order to sustain the business operations in a competitive environment, a company requires to have sound strategies for marketing, communication, research and development, sales, social responsibility.
  • Adobe Inc.’s Five Forces and Leadership Analysis In this paper, the Adobe organization will be assessed through Porter’s Five Forces model, and the employed leadership model will be analyzed.
  • Leadership Theories in Nursing Practice Contingency leadership and transformational leadership theories both focus on investigating components of relative climate, which may impact the productivity of administration.
  • Transformational Leadership in Case of Walt Disney Transformational leadership is an effective model for influencing performance and learning. The style allows workers to receive positive influence and become more involved.
  • Leadership Style and Nursing People have come up with different leadership styles to enable them to manage, motivate and direct their employees.
  • David: The Legacy of Leadership This paper analyzes King David’s life and personality in depth based on the books of Samuel, Chronicles, and Kings as well as defines David’s leadership model and makes a case for its relevance today.
  • Leadership Styles and Their Effect on Employees This study determines the leadership styles employed by managers and the relationship that exists between these leadership styles and their impact on the employees.
  • Role of Ethics in Healthcare Leadership Healthcare administrators use the principle of nonmaleficence to resolve challenges associated with service delivery.
  • Leadership and Army Profession This essay aims to examine the impacts of the Armed Forces leadership principles on military expertise, knowledge, and service competence.
  • The Concept of Sustainable Leadership The paper discusses the true meaning of sustainability leadership. It is a mindful effort of a leader to manage the resources they are in charge of.
  • Franklin D. Roosevelt’s Adaptable Mixed Leadership D. Roosevelt was highly adaptable in his leadership practices, utilizing a mixed-methods approach of democratic leadership and charisma.
  • Apple Inc.’s Strategic Leadership and Innovation Heracleous and Papachroni explore strategic leadership and innovation at Apple, Inc., performed by Steve Jobs, a founder of the organization.
  • Leadership Styles of Benazir Bhutto and Shirin Ebadi This paper aims to compare the leadership styles of Benazir Bhutto and Shirin Ebadi. These two prominent political activists have made a significant influence on their countries.
  • Lego’s Change Under Jorgen Knudstorp’s Leadership Prior to 2004, Lego was focused more on its products than on its marketplace. Then Lego adopted another approach under the leadership of Jorgen.
  • Leadership Styles in the Forrest Gump Film Forrest managed to inspire Elvis Presley, who imitated Forrest’s dance moves. As such, he received a football scholarship and became a top running back.
  • Warren Buffet as a Leader and the Leadership Style That He Embodies The paper argues and discusses company’s survival is greatly influenced by the individual temperament and abilities of its leader.
  • Leadership Style and Change Advocacy Statement The paper aims to examine the problem of nursing staff stress and present thoughts and research on how this issue can be overcome with the help of nursing leadership.
  • Transformational Leadership Approach to Conflict Management in Emergency Care The research stresses the leadership importance in the conflict management process and highlights its vitality for bringing positive changes to the emergency departments.
  • Human Relations: Values, Leadership and Power Human relations is the management process that involves bringing workers’ actions to match those of the company. This work explores topics of HR: values, leadership, and power.
  • Leadership and Team Management Leadership and team management are complex tasks that often go hand in hand. One of those hardships is motivating the team in unfortunate circumstances.
  • Dr. Rosser-Mims’ Diversity Model and Leadership Style The diversity model described by Dr. Rosser-Mims refers to the variety of differences in people’s characteristics and behaviors that are combined in a single environment.
  • Leader-Member Exchange Theory and Transformational Leadership The Leader-Member Exchange Theory focuses on the actual interaction process between the frontrunner and followers, and in theory, it is often referred to as a dyadic relationship.
  • Engaging Others with Leadership Leaders can engage their subordinates through the use of powerful dexterities such as teamwork, appropriate coordination, personal influence, and communication of a vision.
  • Robert Kiyosaki’s Leadership Style The research explores the components of leadership such as transformational leadership and organizational realities in the management style of Robert Kiyosaki.
  • Leadership, Management and Change The essay describes the major theories and models that have the potential to change the manner in which the group was managed and led.
  • Chapter 4 of Dugan’s Leadership Theory Chapter 4 of Dugan’s Leadership Theory primarily focuses on the person-centered theories of leadership: strength-based leadership, emotionally intelligent leadership, etc.
  • Steve Jobs’ Leadership Style and Apple’s Success The paper states that Steve Jobs’ general approach to leadership can be summarized as authoritarian. As an effective leader, he was meticulous in detail.
  • Norman Schwarzkopf’s Leadership Styles The uncanny personal magnetism possessed by General Norman Schwarzkopf enabled him to work with a diverse group of people.
  • Contemporary Leadership Challenges Leadership is one of the most researched topics in social sciences because of its relevance in different fields.
  • Foundations of Army Leadership Leaders influence people not just through the instructions they give, but also through their words and actions.
  • Marriott Hotels: Organisational Leadership and Strategy Marriott Hotels is one of the most multifaceted and internationally assorted organizations of the hospitality industry. The researcher has put emphasize over the leadership of the organization.
  • Change Management at Zoom: Leadership in Organizational Change The ongoing coronavirus disease of 2019 (COVID-19) pandemic has forced entrepreneurs and leaders of giant corporations to transform their business models.
  • Followership Leadership vs. Servant Leadership Followership leadership focuses on followers and servant leadership focuses on leaders, but they are similar since the core element is service, empathy, and proactiveness.
  • Core Values and Leadership Personal values and beliefs are of immense importance to an individual since they dictate what a person judges to be of importance or worth in their lives.
  • Collaboration and Leadership Reflection in Nursing Interprofessional collaboration implies the engagement of several healthcare experts with different backgrounds and specializations to work with patients and their families.
  • Educational Leadership: Literature Review This paper reviews literature on key issues that are necessary for educational leaders such as the provision of vision driven by values to school fraternity and others.
  • Business Management and Leadership Qualities A business leader should possess personal convincing qualities which leads other people’s morale to perform a job which will contribute to the Business’ success.
  • Berkshire Hathaway: Management and Leadership The impact of the efficient and supportive management style of an organisation determine conflict management ability.
  • Steve Jobs’ Leadership Style and Emotional Intelligence This paper will focus on Steve Jobs’s style of leadership, change management leadership, motivating approaches, and emotional intelligence.
  • Transformational Leadership: The Case Study Transformational leadership is a type of organizational governance that not only encourages change and innovation but also maintains its values, culture, and processes.
  • The Strengths and Weaknesses of the Servant Leadership Theory The paper discusses the servant leadership style. It is one of the most controversial management practices. It includes many psychological and practical elements.
  • Reflection on Leadership and Professionalism Leadership is the achievement of an objective through the direction of human assistance. Nobody is born a leader, but an individual becomes a leader
  • Strategic Leadership and Knowledge at Amazon This paper reflects on the strategies to manage knowledge and an analysis of how Amazon leverages and makes use of knowledge as a strategic advantage.
  • Exploring the Effects of the Leadership Style on the Performance of an Organization Leadership styles that help people develop their skills and abilities have been recommended for use by organizations.
  • God’s and Elijah’s Formal and Informal Leadership This paper will discuss formal and informal leadership represented by God and Elijah the Prophet, respectively.
  • Leadership Analysis of St. John the Compassionate Mission The case study portrays an effective governance concept that the administration should implement when treating people and organizing their needs to find an effective solution.
  • Six Leadership Traits: Overview and Definition There are six fundamental leadership traits: vision, honesty, empathy, determination, competence, and motivation. Every successful leader needs to have these traits to be successful.
  • Global Leadership and Organizational Behavior The article’s main theme relates the significance of global teams and how they play their part in this global business environment.
  • FedEx Corporation’s Leadership Experience Interview Being among the largest shipping services in the US, FedEx Corporation presents a public company that values initiative and well-developed leadership qualities.
  • Napoleon Bonaparte: Autocratic and Charismatic Leadership Based on current evidence, Napoleon’s charismatic style can be applied currently while autocratic methods create resistance.
  • Great Man Theory of Leadership An evaluation of the great man will help explain how it reflects the leadership components of the RN’s role and enhances inter-professional practice.
  • Leadership and Management During COVID-19 Pandemic The current leadership framework that lifts a substantial amount of responsibility from the staff might help them feel relieved, yet will reduce the efficacy of their performance.
  • Leadership in Motivating Healthcare Staff to Increase Performance Transformation leadership is an approach that efficiently works to motivate healthcare staff to increase performance and teamwork and to improve patients’ outcomes.
  • Servant Leadership: Chinese Culture and Confucianism It is necessary to note that the principles associated with servant leadership are consistent with the values found in Confucianism and Christianity.
  • A Difference Between Leadership and Management It needs to be understood that leadership and management are different. Most performing managers possess leadership traits, but not all leaders can manage effectively.
  • Authority and Leadership: Rising From the Ranks The goal of this paper is to determine the right line of action for a person who is assigned leader of a team she or he has previously been a member.
  • Situational, Transformational, and Transactional Leadership The purpose of this essay is to examine situational leadership, its fundamental principles, philosophical assumptions, and main elements.
  • Steward Versus Servant Leadership in Christianity Leadership is critical for any organization to succeed. Steward leadership and servant leadership are similar and different in some aspects.
  • Servant Leadership in the Church and Its Purpose This research paper analyzes three main components: the Pastor’s relationship with Leadership, the purpose of Servant Leadership, and the personal qualities of the minister.
  • Analysis of Leadership in the Intensive Care Unit According to van Schijndel and Burchardi, scholars have not paid much attention to practical management in the intensive care medicine.
  • Followership and Servant Leadership This essay compares and contrasts servant leadership and followership in an attempt to highlight their importance.
  • Importance of the Effective Leadership A leader must exhibit traits of accepting and solving wide varieties of business problems and issues, of different hues and have varying levels of impacts on business environment.
  • Servant Leaders in “Jesus on Leadership: Developing Servant Leaders” by Gene Wilkes Gene Wilkes, in his book “Jesus on Leadership: Developing Servant Leaders,” takes his readers back to reflect on how to manage people the way Jesus did.
  • Country-Club Leadership Style in Teaching Profession The leadership style could be defined as country-club management. This approach is characterized by a high concern for the atmosphere and relationships.
  • IBM Company’s Leadership and Innovation Management IBM through the newly appointed CEO took the initiative of making the company employees realize the importance of treating customers as kings.
  • Leadership Role in Shaping Organizational Culture Leadership largely determines how culture is formed and maintained within an organization and ensures the promotion of ethics.
  • Management and Leadership in Healthcare The effectiveness of management of a medical organization can only be guaranteed by the figure of the chief physician as the main head of the clinic.
  • Leadership in “Erin Brockovich” Film In the “Erin Brockovich” movie, the main protagonist, Erin, is a transformational leader, he shows passion and determination until the desired outcome is achieved.
  • Organizational Culture, Structure, and Leadership in the 21st Century International and local companies of the 21st century have to change their missions, organizational culture, structure, power division, reward system, and leadership styles.
  • Emotional Intelligence and Leadership In the paper, the effects of Emotional Intelligence level on leadership in the clinical settings will be addressed in detail along with the recommending tool for it assessment.
  • Leadership and Change in Healthcare Management The paper outlines the essence of leadership and change in healthcare management focusing on the Patient safety, Understanding organizations, Health care management.
  • Wise Men’s Leadership in the Old Testament The Old Testament is a great book of universal human significance since it carries information about not only religion but the state and power structure.
  • Philosophy of Nursing Leadership: Transformational Leadership Philosophy A transformational nursing leadership philosophy is a modern concept that helps healthcare organizations to adapt to present exterior environmental strains.
  • A Case Study on Educational Leadership The paper analyzes the case and identifies the problems within the school, with poor leadership being the priority issue and looks for subsequent improvement.
  • Angela Merkel’s Leadership Style – Article Evaluation Angela Merkel is a transformational leader as demonstrated by her role in the Euro Crisis. The German economy still enjoys a strong position in Europe.
  • Contemporary Theories on Leadership The paper describes different contemporary theories on leadership and shows example of leadership style by Richard Branson, the founder and Chief Executive Officer of Virgin companies
  • Leadership and Organizational Behavior: U.S. and India In this paper, we will discuss the communication differences between U.S. and India, analyze the cultural and workforce differences, and would devise a strategy to deal with HRM issues.
  • Ford Motor Company’s Strategic Leadership With Mulally as the new CEO, Ford’s strategic leadership will assist in the meeting of the objectives of the company.
  • Individual Leadership Development Plan and Report The individual leadership development report focused on conducting a self-assessment to help outline and explain my personal strengths and weaknesses.
  • Leadership Example for Exxon Mobil Top Management The present case study focuses on the leadership style used by the NYC Comptroller, Mr. Scott M. Stringer. The target audience of the report is the top management of Exxon Mobil.
  • Nelson Mandela’s Servant Leadership Principles This paper examines how Nelson Mandela employed servant leadership traits to lead, motivate, and influence others.
  • Seven Leadership Mindsets Theory The analysis of the company using Seven Leadership Mindsets Theory helps to differentiate the existence of particular structures and systems that impact its work and to a certain degree precondition outcomes.
  • Wal-Mart’s Leadership in Crafting and Executing Strategy Wal-Mart Company was selected because it was associated with sustainable business strategies capable of fulfilling the emerging needs of more stakeholders.
  • Leadership Style and Its Impact on Employees: Case Study Analysis The paper analyze how leadership style affects the job satisfaction and emotional well-being of employees, including considering one’s own example.
  • A Leadership Development Plan for a Nurse Manager The most critical strategy for the leadership development plan is to focus on the transformation of the employees.
  • Leadership Styles and Macbeth’s Leadership
  • Servant Leadership in Early Childhood Education
  • The Importance of Effective Leadership in Public Safety
  • Benedict Arnold’s Leadership Traits
  • Diversity and Inclusion in Educational Leadership
  • Leadership Theory and Practice
  • Leadership in Healthcare Overview
  • Leadership in Organizational Behavior
  • Cultural Difference in Leadership and Communication
  • Communication and Leadership in Nursing
  • Nursing Leadership and Management: Isaac’s Case
  • Responsible Leadership and Followership in Africa
  • Maimonides’ Definition of Prophecy and Political Leadership
  • Leadership Styles and Employee Performance
  • A Self-Assessment of Leadership
  • Followership and Leadership in Healthcare
  • The Differences between Leadership and Management
  • Dominant and Backup Leadership Styles
  • Change Leadership in the Baptist Health South Florida Hospital
  • Transformational Leadership the Field of Nursing
  • Nelson Mandela’s Leadership
  • Personal Development and Leadership Program in Education
  • Barack Obama’s Leadership Qualities
  • Communication Effects on Leadership
  • The Importance Role of Leadership in Nursing
  • Criminal Justice Leadership: Challenges in the Present and Improving for the Future
  • Holistic Thinking in Leadership
  • Transformational & Transactional Leadership Theories
  • Transformational Leadership and Patient-Centered Care
  • Richard Branson’s Leadership and Philosophy
  • Nursing Leadership: Plan of Action
  • Richard Branson’s Leadership Style
  • Leadership and Management Importance in Organisations
  • Humility’s Impact in Leadership
  • Leadership at the Children’s Hospital of Philadelphia
  • Personal Leadership Portrait: Leadership Reflections
  • Amazon: The Leadership Strategies
  • Goleman’s and Classic Leadership Styles
  • Transformational Leadership in Nursing
  • Women’s Role and Leadership in the Church
  • Leadership Psychology and Behaviors
  • Leadership, Management Style and Organizational Performance
  • Leadership Styles Comparison: Authoritarian, Democratic, and Laissez-Faire Leadership
  • Richard Branson’s Rule-Breaking Leadership Style
  • Transformational Leadership and Management
  • Leadership in Cross-Cultural Context
  • Leadership in Project Management and Team-Building
  • The Impact of Humility and Leadership
  • Servant Leadership in the Remember the Titans Film
  • Role of Leadership in Managing Patagonia’s Change
  • General Motors Firm’s Leadership Approaches
  • Sonia Sotomayor: Character and Leadership
  • Advocacy in Nursing Leadership
  • Change-Oriented Leadership: The Effectiveness of Transformational and Charismatic Leaders
  • Leadership: Definition and Key Issues
  • Leadership and Organizational Change: Diversity and Globalization
  • Alexander The Great’s and Wellington’s Leadership Styles
  • “José Mourinho: Special Leadership” by Luis Lourenço
  • The Idea of Leadership: “Servants of the Servant” by Don N. Howell, Jr.
  • The Leadership Model in Nursing
  • Leadership Development in Government Sector
  • Participative Leadership Style and Its Benefits
  • The Role of Values in Leadership
  • Project Manager’s Leadership Qualities for Success
  • Carlos Ghosn’s Leadership at Nissan Motor Co.
  • Margaret Whitman’s Leadership: EBay Company’s Case
  • Facebook Inc.’s Leadership Practices
  • New Leadership Theories: Servant, Spiritual, Authentic and Ethical Leaderships
  • Google Company: Leadership and Motivation
  • Leadership Development Strategy for Human Capital
  • Nursing Leadership Styles and Model Case
  • GLOBE Study of Leadership for Multinationals
  • Leadership: Challenges, Change and Responsibility
  • Taxonomy of Leadership Theories
  • Organizational Culture, Structure, and Leadership in the 21st century
  • Apple’s vs. Walmart’s Organizational Leadership Strategy
  • Nurture and Nature in Leadership
  • Abusive Leadership Effects on Employee Performance
  • Cici’s Pizza’s Business Approach, Leadership Style, and Competitive Vulnerabilities
  • Ineffective Leadership in Business
  • Role of Leadership Style in Organizational Change
  • Followership and Servant Leadership in Army Officers
  • Adaptive Leadership in Health Care
  • Effective Leadership: Leadership Requirements Model
  • Effective Leadership Styles and Its Roles
  • Leadership and Management in the Patient-Centred Care
  • Leadership Theory: Personal Experiences
  • Being a Leader: My Leadership Capabilities Evaluation
  • Delegation in Leadership Process
  • Delegation of Leadership Skills
  • Path-Goal Theory of Leadership
  • Skills Approach: Personal Leadership Reflection
  • Organizational Behavior Aspects and Leadership Style
  • The Key Academic Themes of 21st Century Leadership
  • Chipotle Mexican Grill Inc.’s Leadership Outcomes
  • Skrill Limited Company: Leadership and Management
  • The Leadership of Richard Branson
  • Good Leadership and Its Importance in Nursing
  • Leadership Competencies in Nursing
  • Servant Leadership in a Police Organization
  • John Gardner: Contributions to Community Leadership
  • Instrumental Values as a Tool in the Leadership Approach
  • The Leadership Development Plan
  • Effective Leadership and Management in Nursing
  • Practicum Project on Developing and Strengthening Leadership and Management Skills of Nurses
  • The Definition of Public Health Leadership
  • The Visionary Leadership
  • Leadership in Different Spheres of Life
  • Creating a Positive School Culture: The Servant Leadership Style and Facilitative Leadership
  • Leadership in the Context of Globalization
  • Nursing Leadership Experience in the Development of an Educational Program for Patients
  • Transformational Leadership of Jesus Christ
  • Personality Type and Leadership in Healthcare
  • Gamal Abdel Nasser’s Political Leadership
  • Leadership Skills Analysis and Comparison
  • Warren Buffet’s and Al Gore’s Leadership Styles
  • Different Leadership Styles Comparison
  • Effective Nursing Leadership Skills and Approaches
  • Leadership History and Evolution
  • Leadership in Nursing and Midwifery
  • Women in International Business and Leadership
  • A Social Identity Theory of Leadership by Michael Hogg
  • The Role of Leadership: Crisis Management
  • Leadership in Health Administration
  • A New Model for Ethical Leadership by Bazerman
  • Leadership in Sports: Sport Psychology
  • Psychology of Leadership Theories
  • Servant Leadership, Emotional Intelligence, and Performance
  • Leadership in Church and Its Theological Aspects
  • The Samsung Firm’s Leadership Failure
  • Elon Musk: Evaluating Leadership in the United States
  • Servant Leadership and Communication: Islam Religion and Indian Culture
  • Ethical Leadership Virtues Questionnaire
  • Effectiveness of Leadership: The Case Study
  • Transformational Versus Servant Leadership
  • Foundations of Leadership in the Army
  • Leadership and Communication in Healthcare Setting
  • Leadership Strategies for Conflict Management in Nursing
  • Leadership and Self-Deception Analysis by Arbinger Institute
  • Hospital-Acquired Infections: Leadership Action Plan
  • Leadership Styles: Buffet and Ghosn
  • Gender Issues in the Leadership of the Organization
  • Leadership and Self Empowerment
  • Ethics in Business Leadership
  • The Problem of Leadership
  • Assessment of Leadership Capabilities
  • Leadership Problems: Organizational Change
  • Leadership & Management: What the Future Looks Like
  • Leadership Effectiveness and Its Factors
  • Todd McFarlane’s Leadership Approach
  • Transformational Leadership in Pakistan’s Banking Sector
  • Positive Leadership Styles for Organisational Performance
  • The Interrelationship Between Leadership and Management
  • Jack Welch’s Leadership at General Electric
  • Workplace Violence and Leadership Styles in Nursing
  • Crucibles of Leadership: Professional and Personal Growth
  • Leadership and Globalization in the US and Japan
  • Master’s Education in Nursing and Leadership Skills
  • Oprah Winfrey’s Leadership and Change Competency
  • Motivation Types and Leadership Styles in Nursing
  • Leadership Styles in Business
  • Trust and Transparency in Management and Leadership of Health Care Organizations
  • Role of Delayed Gratification in Leadership
  • Satya Nadella’s and Ken Lay’s Leadership Styles
  • Leadership for Strategy Execution
  • Personal Leadership Philosophy Statement
  • Leadership of a Priest: Interview Experience
  • Authentic and Servant Leadership
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StudyCorgi. (2021, September 9). 611 Leadership Essay Topics & Research Questions. Retrieved from https://studycorgi.com/ideas/leadership-essay-topics/

StudyCorgi. (2021, September 9). 611 Leadership Essay Topics & Research Questions. https://studycorgi.com/ideas/leadership-essay-topics/

"611 Leadership Essay Topics & Research Questions." StudyCorgi , 9 Sept. 2021, studycorgi.com/ideas/leadership-essay-topics/.

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StudyCorgi . 2021. "611 Leadership Essay Topics & Research Questions." September 9, 2021. https://studycorgi.com/ideas/leadership-essay-topics/.

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These essay examples and topics on Leadership were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

This essay topic collection was updated on January 8, 2024 .

Transformational Leadership Essays (Examples)

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Leadership Development Plan

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Essays on Transformational Leadership

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To many learners, composing Transformational Leadership papers comes easy; others need the help of various types. The WowEssays.com collection includes expertly crafted sample essays on Transformational Leadership and relevant issues. Most definitely, among all those Transformational Leadership essay examples, you will find a piece that get in line with what you imagine as a worthy paper. You can be sure that virtually every Transformational Leadership work presented here can be used as a bright example to follow in terms of overall structure and composing different parts of a paper – introduction, main body, or conclusion.

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Free Leadership And Ethics Essay: Top-Quality Sample To Follow

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“Ethical Leadership is defined as "the demonstration of normatively appropriate conduct through personal actions and interpersonal relationships, and the promotion of such conduct to followers through two-way communication, reinforcement and decision-making" [and] the evidence suggests that ethical leader behavior can have important positive effects on both individual and organizational effectiveness”

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Management and Leadership

Business Management and Leadership In order to meet the requirements of the given task, I would highlight two aspects of leadership and then incorporate them into my personal leadership development plan. Although there are several qualities of a leader and a leader serves to provide the right direction to its followers whenever and wherever necessary, I will focus on two main areas of leadership which are motivation and transformational leadership.

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Why Data Breaches Spiked in 2023

  • Stuart Madnick

essay topics on transformational leadership

And what companies can do to better secure users’ personal information.

In spite of recent efforts to beef up cybersecurity, data breaches — in which hackers steal personal data — continue to increase year-on-year: there was a 20% increase in data breaches from 2022 to 2023. There are three primary reasons behind this increased theft of personal data: (1) cloud misconfiguration, (2) new types of ransomware attacks, and (3) increased exploitation of vendor systems. Fortunately, there are ways to reduce the impact of each of these factors.

For many years, organizations have struggled to protect themselves from cyberattacks: companies, universities, and government agencies have expended enormous amounts of resources to secure themselves. But in spite of those efforts, data breaches — in which hackers steal personal data — continue to increase year-on-year: there was a 20% increase in data breaches from 2022 to 2023 . Some of the trends around this uptick are disturbing. For example, globally, there were twice the number of victims in 2023 compared to 2022, and in the Middle East, ransomware gang activity increased by 77% in that same timeframe.

  • Stuart Madnick  is the John Norris Maguire (1960) Professor of Information Technologies in the MIT Sloan School of Management, Professor of Engineering Systems in the MIT School of Engineering, and Director of Cybersecurity at MIT Sloan (CAMS): the Interdisciplinary Consortium for Improving Critical Infrastructure Cybersecurity. He has been active in the cybersecurity field since co-authoring the book Computer Security in 1979.

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Transformational Leadership and Change Essay

Management of change.

A successful change requires managers to mobilize resources effectively and to overcome cultural barriers and psychological resistance to the planned alterations in the internal environment of a company. For this reason, among all other leadership styles, transformational leadership is the most conducive to any intended organizational changes. It comprises three basic elements: inspirational motivation, intellectual stimulation, and individual consideration. The first one implies the development of a shared vision and inspiring others for action (Middleton et al, p. 156). The second one refers to engaging employees in decision-making and challenging them to evaluate the value of the status quo and the planned changes both independently and collectively (Middleton et al, p. 156). Lastly, individual consideration means that a leader takes into account the personal characteristics and interests of each subordinate (Middleton et al, p. 156). Together these three components of transformational leadership help to foster the right attitude to organizational change among workers through active and mutual communication and the establishment of positive relationships.

Consultants’ Role in Change Process

Consultants can play a major role in companies’ change management processes, and the contribution of an external consultant can be particularly valuable when delivering any improvement initiatives (Alagoz et al., p. 1). External change agents are not bound by internal corporate policies, culture, and values and are, thus, more capable to evaluate internal situations in an unbiased and unprejudiced manner (Alagoz et al. p. 1). Considering this, consultants can provide a fresh view of the problems of organizational interests. However, it is valid to say that the ability of a consultant to deliver largely depends on the level of their professionalism, as well as the quality of their cooperation with internal coordinators, including managers and company leaders. Overall, to formulate realistic change goals and management plans, a consultant should both understand internal factors, such as personnel characteristics and operating procedures, and be aware of major external trends driving the change.

Works Cited

  • Alagoz, Esra et al. “The Use of External Change Agents to Promote Quality Improvement and Organizational Change in Healthcare Organizations: A Systematic Review.” BMC Health Services Research , vol. 18, no.42, pp. 1-13.
  • Middleton, Jennifer, et al. “Transformational Leadership and Organizational Change: How Do Leaders Approach Trauma-Informed Organizational Change…Twice?” Families in Society: The Journal of Contemporary Social Services , vol. 96, no. 3, 2015, pp. 155-163.
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"Transformational Leadership and Change." IvyPanda , 16 Jan. 2022, ivypanda.com/essays/transformational-leadership-and-change/.

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  1. Essay on Transformational Leadership

    Essay on Transformational Leadership > Free Essays > Business > Management Transformational Leadership Essay Exclusively available on IvyPanda Updated: Oct 28th, 2023 Introduction In any organization, the focus is based on yielding high profits. The key to this lies in the leader, who in turn inspires the staff.

  2. 50 Brilliant Leadership Essay Topics [2024 Updated]

    Updated: January 8, 2024 26.2K Table of Contents ️How To Select? 📢General 🔥Viral 📝More Questions 💡Ideas While exploring the concept of governance, leadership essays can take different formats. The topic you choose can significantly contribute to the format you will apply to your paper.

  3. Transformational Leadership: How to Inspire and Motivate

    Transformational leadership is a leadership style that can inspire positive changes in those who follow. Transformational leaders are generally energetic, enthusiastic, and passionate. Not only are these leaders concerned and involved in the process, but they are also focused on helping every member of the group succeed.

  4. What is Transformational Leadership? (Examples + How-To)

    Practical Psychology on November 2, 2023 You're on a quest to become a better leader, and you've stumbled upon a term that keeps popping up: transformational leadership. You're in the right place to find out what it means, why it matters, and how it could change your life and the lives of those you lead.

  5. 45+ Transformational Leaders (Examples

    Transformational leaders are like awesome coaches who not only guide their team but also inspire everyone to be better. They bring big changes and make people want to follow them because they have great ideas and a way of making everyone feel important. In this article, we'll explore leadership and why it's so important.

  6. 159 Leadership Essay Topics & Ideas

    Top Leadership Essay Topics. Examining Leadership Styles in Diverse Cultural Contexts. Transformational Leadership: A Key to Organizational Change. Charismatic Leadership and Its Influence on Team Dynamics. Ethical Boundaries in Leadership: A Closer Look. Women in Leadership: Challenges and Opportunities.

  7. Transformational leadership effectiveness: an evidence-based primer

    2 CrossRef citations to date 0 Altmetric Listen Perspective Articles Transformational leadership effectiveness: an evidence-based primer Connie Deng , Duygu Gulseren , Carlo Isola , Kyra Grocutt & Nick Turner Pages 627-641 | Received 20 Jun 2022, Accepted 30 Sep 2022, Published online: 13 Oct 2022 Cite this article

  8. Transformational Leadership Essays: Examples, Topics, & Outlines

    Transformational Leadership Essays (Examples) 874+ documents containing "transformational leadership" . Sort By: Most Relevant Keyword (s) Reset Filters Transformational Leadership Which CEO or Company Most PAGES 3 WORDS 894 Transformational Leadership hich CEO or Company Most Represents Authentic Leadership and hy

  9. Transformational Leadership Theory: Inspire & Motivate

    Transformational leadership is a leadership style where leaders inspire, motivate, and stimulate their followers intellectually to work towards a shared and valued goal. These leaders encourage innovation, creativity, and personal development among their team members, fostering an environment of trust, respect, and admiration. They aim to transform their followers' individual and collective ...

  10. Transformational Leadership and Evidence-Based Management

    TRANSFORMATIONAL LEADERSHIP: THE ESSENTIAL PRECURSOR. The central function of leadership is to achieve a collective purpose (Burns, 1978). Not surprisingly, leadership has been observed to be the essential precursor to achieving safety in a variety of industries (Carnino, undated), a critical factor in the success of major change initiatives (Baldridge National Quality Program, 2003; Davenport ...

  11. 611 Leadership Essay Topics & Research Questions

    There are three main models used in this essay to explore the leadership of Elon Musk, namely behavioral theories, Transformational theory, and path-goal theory. The Case of Nokia: A Lesson in Leadership and Motivation. In the 1990s and 2000s, the Finnish company Nokia was a global phenomenon.

  12. The Benefits of Transformational Leadership Essay

    Learn More. This review will identify the benefits of transformational leadership and show how positive outcomes for employees can be achieved. Overall, this model can bring significant improvement as increased job satisfaction, creativity, and better performance, but this approach can be successful only leaders possess a variety of skills.

  13. Transformational Leadership: Essential Strategies Essay

    Transformational Leadership: Essential Strategies Essay. The article "4 Actions Transformational Leaders Take" discusses the essential strategies to help leaders increase their chances of success in transforming a company. Investors, employees, and customers hold organizations to extremely high standards in the current business environment.

  14. Transformational Leadership Essays

    Pages: 5 (1542 words) Sources: 5 Document Type: Essay Document #: 47234629. Part One. My Personal Model: transformational leadership. My own personal model of leadership is transformational leadership. This model focuses on giving following a vision of what they should work to become.

  15. Transformational Leader Essays: Examples, Topics, & Outlines

    The transformational leader engages with others in such a way that the leaders and followers raise one another to higher levels of motivation and morality. In transformational leadership, it is important that the leader should address the true needs of the followers, and lead followers towards fulfillment of those needs.

  16. Transformational Leadership Essay

    A transformational leader exhibits specific traits and behaviors to inspire and motivate a team or organization to rally around a shared vision or goal. These behaviors and characteristics include charisma, intellectual stimulation, inspirational motivation 295 Words 2 Pages Satisfactory Essays Preview

  17. Transformational Leadership : A Transformational Leader Essay

    Essay On Transformational Leadership Transformational leadership consists of four components, being charisma or idealized influence, inspiration and vision, intellectual stimulation and individual consideration (Marshall, 2011).

  18. Transformational leadership

    Transformational leadership model proves to be efficient not only in business, but in all other sectors where it is implemented. In order to strengthen the position of transformational leadership, so examples from the past and present are portrayed in this essay. In a historical perspective, Yates (2002) describes about Genghis khan.

  19. Transformational Leadership Theory: Pros and Cons Essay

    Updated: Dec 20th, 2023. Transformational leadership is a type of management and control that seeks to bring change to individuals, organizations, or societies. According to Rodríguez Aboytes and Barth (2020), at its best, transformational leadership not only leads to a positive change for the organization but also seeks to leaders growing ...

  20. Essays About Transformational Leadership ️ Free Examples & Essay Topic

    Free essays on Transformational Leadership are focused on the key concepts and ideas of transformational leadership. These essays aim to provide an overview of the principles, practices, and benefits of transformational leadership that can help individuals, groups, and organizations achieve their goals and objectives.

  21. Transformational Leadership Essay Examples

    Get your free examples of research papers and essays on Transformational Leadership here. Only the A-papers by top-of-the-class students. Learn from the best!

  22. Transformational and Transactional Leadership

    We will write a custom essay on your topic a custom Essay on Transformational and Transactional Leadership. 808 writers online . Learn More . ... Transformational leadership, just as the name suggests, is concerned with bringing change to the society or organization. It is a type of leadership characterized by stimulation and inspiration of the ...

  23. Followership VS Servant Leadership: Comparison and Analysis

    Followership vs servant leadership BLC essay gives briefly This essay will compare and contrast followership and servant leadership. Although both topics are different, neither can be comprehended without understanding the other. In life, there have to be followers for there to be leaders in any organization.

  24. Why Data Breaches Spiked in 2023

    Post. In spite of recent efforts to beef up cybersecurity, data breaches — in which hackers steal personal data — continue to increase year-on-year: there was a 20% increase in data breaches ...

  25. Transformational Leadership and Change

    Together these three components of transformational leadership help to foster the right attitude to organizational change among workers through active and mutual communication and the establishment of positive relationships. We will write a custom Essay on Transformational Leadership and Change specifically for you for only 9.35/page.