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   Dimensions of Effective Leadership in healthcare institutions: A Vision for tomorrow
Adaptiveness is best in systems where elements/pieces are optimally connected. Too rigid connection causes obstructions and too loose a connection results in chaos. The challenge is to first observe and diagnose the latent socio-cultural perspective of society, and see how the target customer fits in there

LEADERSHIP VS. MANAGEMENT
The relationship between leadership and management has generated considerable interest in the leadership literature. It’s also led to a great deal of confusion, both in classroom and in the workplace. Broadly speaking, leadership and management are different concepts that have a considerable amount of overlap. They are different in that management traditionally focuses on the activities of planning, organizing, staffing, and controlling, whereas leadership emphasizes the general influence process. According to some researchers management is concerned with creating order and stability while leadership is about adaptation and constructive change (8). Other researchers go as far as to argue that managers and leaders are different types of people, managers being more reactive and less emotionally involved. (9) The overlap
between leadership and management is centered on how they both involve influencing a group of individuals in goal attainment.

Abraham Zaleznik, in an article in the Harvard Business Review, entitled “Manager and Leaders: Are they Different?” remarked that managers are consensus driven – motivated more by questions of procedure than by issues of substance – while leaders follow their own vision rather than swaying in compromise to the group (10). Leaders have the courage of their own convictions. Genuine leaders sometimes inspire dread and fascination along with dedication, but they make things happen: they make a real difference in the organization. Managers, for their part, simply implement the leader’s vision. This function is important too, of course – but it’s not leadership.

The leadership scholar Warren Bennis puts the distinction between leadership and management very nicely: He distinguishes between “doing the right thing” and “doing things right”(11). Others make the distinction that we “manage things” but we “lead people”. Etymologically speaking, the word manager comes from the Latin word manus, meaning “hand”. From that root it branches into the Italian word maneggiare and the old French manege – meaning training and directing horses in the manege, or riding school! In contrast, the word leader comes from the Anglo-Saxon word laed, meaning “path” or “way”(12). Thus a leader is one who shows fellow travelers the way by walking ahead.

LEADERSHIP DIMENSIONS – A FUTURISTIC MODEL
Having explored the foundations of our images of leadership we now move on to a conceptual tool that enables us to describe effective leadership behavior in the healthcare institutions of tomorrow. This section and others that follow provide such a tool, the Multidimensional Leadership Model (see figure 1). The model helps us to analyze the future challenges, which leaders in the healthcare settings would be facing, and the skills they would need to meet these challenges with success.

VISION
An essential part of the futuristic leadership role revolves around visioning. A vision assists in seeing beyond today to what is desired for tomorrow. Leaders need to develop a vivid vision of a future state that conveys the fundamental reason for the existence of the healthcare facility they are working for. Once they have developed that vision of the future, they need to articulate it, and share it with the entire healthcare team of the institution. The leader must have the ability to communicate the vision to others. It is a rare vision that does not require the enthusiasm, energy, and talents of others to achieve it. An effective vision requires clarity of purpose, passion, and evidence of how the vision can make a difference so that others can understand and embrace it.

Envisioning involves a number of things, including providing a road map for future direction, building excitement about that direction, creating order out of chaos, instilling confidence and trust in leadership, and offering criteria for success. Through the process of envisioning a better future, leaders provide meaning, forge a connection between themselves and other people in the organization, create a group identity, and trigger the collective imagination that connects people and helps them dream. If the leader’s vision is inspirational, promising an exciting future, then it creates a sense of pride among the people in the organization, pushing them to strive for further success.

Visions also help urge people toward a common goal, to develop a compelling sense of direction (13). After articulating the vision the leader helps the institution focus its resources on supporting initiatives and strategies that can achieve this vision. The most important strategy is to enable others to act. Enabling others to act requires the leader to recognize the contributions others make toward achieving the vision. The basic desire of people to make a difference can be used by enlisting their ideas and talents, listening to their suggestions, and trying to incorporate them. The more people believe they can influence a desired outcome, the greater their satisfaction and willingness to stay committed and engaged in the process.

VALUES
Values are deeply held views that act as guiding principles for individuals and organizations. When they are declared and followed they are the basis of trust. When they are left unstated they are inferred form observable behavior. When they are stated and not followed trust is broken. Health care institutions have quite a few values they hold most dear, yet they tend to emphasize their standards, instead. Standards and values are similar in many ways. Both are most powerful when they are declared. Both act as guiding principles. There’s, however, an important difference between the two. Values state what is important; standards state what is good or acceptable. Values tend not to vary, whereas standards – both the current standards that have been achieved and what is regarded as acceptable standards – may well vary.

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