Leadership from a systems perspective
By: Leslie Ann Fox, MA, RHIA
At the dawn of the 21st century, we bask in the light of progress. Technological, economic and political progress during recent years offers more people than ever the opportunity for longer, healthier and more satisfying lives. In a society that places a high value on the health of its members, health information management (HIM) is a profession that offers great opportunity to its practitioners for professional growth and development. Our knowledge and skills are and will continue to be in great demand. Key to the success of HIM professionals is their capacity for leadership in the health care arenas and organizations in which they choose to practice.
Many outstanding writers have described leadership in so many different ways over the years, one might wonder what more is left to say. It is the very lack of broad consensus about the essence of leadership that makes it a personal and intriguing subject, one that everyone can and perhaps should explore. I believe leadership is a universal responsibility. At one time or another in everyone's life, the successful functioning, or even survival, of one's family, organization, department, work team, church, synagogue or social club may depend on the ability to step up and be a leader.
So important is this aspect of our lives, that in this year's series of Hands-On Help columns I will examine leadership in the workplace, using Bowen Family Systems Theory as the theoretical basis of my discussions. Referencing the theory's concepts of emotional process that I discussed in last year's print columns, I will illustrate principles of leadership that I have derived from the theory, through a new series of case studies.
Focus on Self, Not Others
My first principle of leadership is "focus on self, not others." Living by this
principle suggests introspection. Four self-focused questions to always keep in
mind are:
Thinking about the four questions is important for developing a leadership presence. When a system is threatened, either by real or perceived demons, the members of the system become anxious and their performance goes down. (See "Emotional Process in the Workplace Can Impact Job Performance," ADVANCE for Health Information Professionals, March 15, 1999>.)
When the performance of others in the system is falling, it appears counterintuitive to focus on self and not on those whose performance is suffering. However, a leader's effectiveness is tied directly to her "presence" in the group. An "anxious presence" is likely to escalate further the system's anxiety, creating more problems. A leader who focuses on self, and chooses to reduce her own anxiety, can be a "calm presence," thereby lowering anxiety in the system and allowing functioning to improve. Being calm in an anxious system requires a conscious act of containing or managing one's own anxiety. It does not come naturally!
For example, we have all seen an unruly classroom of children suddenly come to order when the teacher walks calmly, but purposefully, into the room. She may simply look intently at the class and after a moment of quiet, the lessons begin and the classroom becomes a functioning system. The teacher's leadership effectiveness comes from her presence not just her formal position. If the teacher had come into the room shrieking at the children, berating them for their behavior, quiet may have been restored by virtue of the teacher's position of authority, but frightened or demoralized students are still anxious. They do not focus well on learning, and the system does not function as intended.
Case Study
The director of HIM heard shouting near the doctor's incomplete record room. As
she walked toward the room she realized that the correspondence clerk and the
clerk from the incomplete record-processing area were having a heated argument.
She noticed that other employees in the department were quiet, but had stopped
working, waiting to see what would happen next. As the director got closer to
the room, a physician stepped out into the hall asking about the commotion. The
director had a moment of panic when she realized the doctor was the chief of
staff, but she quickly moved to say hello to the physician, asking him if he
needed assistance. Almost simultaneously, she turned to the two employees,
calmly telling them to meet her in her office in five minutes.
After chatting briefly with the chief of staff, the director walked slowly back to her office to meet with the employees who had been arguing. She took a few deep breaths and stopped to make small talk with a few of the other employees along the way, all for the purpose of calming herself. When she met with the employees, she did not first seek to determine who was "right" and who was "wrong," she simply stated her position on using raised voices in the department. "Arguing loudly was not acceptable under any circumstances," she stated in a quiet but firm voice. She reminded them of the consequences of further arguing or another incident, citing the employee handbook on proper conduct in the workplace. Finally, she suggested that if they could not resolve their issue in a professional manner, they were welcome to make an appointment to speak with her individually.
While the outcome of this story is yet to be played out, it is an example of a director who exhibited leadership presence. She made a conscious effort to calm herself in a tense situation. She clearly expressed her beliefs about behavior in the workplace, using facts to support her position. She demonstrated her belief that adults can resolve their own disagreements by allowing the employees to work things out themselves, and offered the alternative of additional counseling if the individuals expressed a need.
Finally, it is important to acknowledge that a leader is part of the relationship system, not separate from it. If the problem persists, it will be important for the director to determine what her role is in contributing to the problem. This is the most difficult part of leadership for all of us, question number one above, figuring out the part you play in the problem.
The concepts of self-focus and presence are key ones in viewing leadership through the lens of systems thinking. Every member of the system affects overall functioning. However, leaders have the most profound impact on system functioning. Individuals, who can tolerate the reactivity of others, without distancing or becoming reactive themselves, are the true leaders at a given point in time. A person who is clear about his or her beliefs, and communicates those beliefs, regardless of how they might be received by others, creates a presence that energizes the system. That presence is a core quality of leadership. One achieves such clarity by focusing on self, not others. And, every individual can work toward that goal.
References
Friedman, Edwin H., A Failure of Nerve: Leadership in the Age of the Quick Fix, The Edwin Friedman Estate, Bethesda, Maryland, 1999. Kerr, Michael E., and Murray Bowen, Family Evaluation: An Approach Based on Bowen Theory, New York: W.W. Norton & Co., 1988.