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Management and Leadership in Dental Public Health

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Presentation on theme: "Management and Leadership in Dental Public Health"— Presentation transcript:

1 Management and Leadership in Dental Public Health
Slide #1 This lecture will briefly discuss management and leadership functions in dental public health.

2 Outline Difference between management and leadership Management tools
Leadership and change Organizational change Slide #2 The lecture will define the difference between management and leadership; describe management tools; discuss leadership and change in organizations; and how to change organizations.

3 Management vs Leadership
There are good managers who are not innovative leaders; they are just good status quo leaders Leaders must be good managers; but to be a great leader requires a whole set of skills and experiences Slide #3 There is a difference between management of an organization and leadership. Good leaders must be good managers. Management addresses how best to use the resources available to achieve the mission of the organization. Leadership focuses on new innovations and allocation of resources to achieve their mission.

4 Management Slide #4 First, let us focus on management of organizations.

5 Slide #5 Good managers understand that their work is interdependent and they are not free to implement new ideas or program before forming networks. Their source of power depends on earning the trust of their subordinates. They are team leaders, and they make changes to promote better performance in the team they lead. Hence, management is about teamwork and leadership. Management also involves skills in resource allocation, analysis, and setting key performance measures for all individuals and programs.

6 Management Improve performance against agency mission
Win over stakeholders Create a roadmap Identify performance objectives Set priorities Roll out the change program Take a comprehensive approach Slide #6 Managers should focus on improving performance against agency mission, win over stakeholders, and create a roadmap for improving the performance of the team members and organization by defining objectives and setting priorities. Successful managers view all operations of the organization.

7 Team members Hiring The most difficult process Heavy price for failure
Slide #7 Managers are responsible for hiring team members, which is a difficult process. They pay a heavy price for failure when the wrong individual is hired.

8 Enemies of Trust Inconsistent messages Inconsistent standards
False feedback Failure to trust others ‘Elephant in the parlor’ Rumors Slide #8 Managers depend on trust to operate their organization. The enemies of trust are inconsistent messages, inconsistent standards, providing false feedback; failure to trust others; reluctance to discuss major issues; and dependence on rumors.

9 Slide #9 Managers should be aware that their actions and words will be interpreted by their team members. There is no private conversation, no casual conversation, and in some organizations, people will immediately jump to the most paranoid, negative interpretation of all comments and movements.

10 On the folly of rewarding A, while hoping for B. Kerr S
On the folly of rewarding A, while hoping for B. Kerr S. Academy of Management Executives 1995;9:7-14. Whether dealing with monkeys, rats, or human beings, it is hardly controversial to state that most organisms seek information concerning what activities are rewarded, and then seek to do those things, often to the virtual exclusion of activities not rewarded. Slide #10 Another management pitfall is the reward system. Rewards should promote the objective and priorities set by the managers and organization. If, for example, the organization demands teamwork but reward individuals, then teams will not function. The classic example in academic institutions is that rewards are based on research funding and not quality of teaching.

11 Leadership Slide #11 Now we will discuss leadership. Leadership is even more difficult than management.

12 Vision There is a process for developing vision.
An understanding of the environment and defining of the problems facing an organization are prerequisites for developing a realistic and direct vision. Slide 12 Leaders should communicate a clear vision for the organization. To develop a vision, a leader must be able to analyze the root causes of the problems facing an organization, understand the environment inside and outside the organization, and formulate a guiding vision that should also be shared with members of the organization.

13 Leadership from the trench
Leadership, like swimming, cannot be learned by reading about it. Henry Mintzberg Slide #13 Leadership cannot be taught it must be learned through reflection, analysis, and taking risks.

14 Failure is a Prerequisite
Many of life's failures are people who did not realize how close they were to success when they gave up.   Thomas Edison Slide #14 Leaders should expect and welcome failure because they learn more from their mistakes than their successes.

15 Accuracy does not matter, all the time
To achieve the impossible,one must think of the absurd; to look where everyone else has looked, but to see what no else has seen.     Unknown Slide #15 Leaders should be able to develop ideas outside of the norm of the organization, challenge the status quo, and seek new horizons.

16 Resiliency in Organizations
The middle of every successful project looks like a disaster.      Rosabeth Moss Cantor Slide #16 Leaders also should be comfortable with dealing with chaos; it is associated with each new project or program.

17 Management and Leadership
Introducing challenges that the culture cannot address All players participate in planning Information sharing Making adversaries stakeholders, building relationships, and making positive political strategies Slide #17 Leaders also face the challenge of introducing changes that challenge the current culture. To ensure that change is moving forward, all players must participate in planning, and information must be shared. Leaders must work with the stakeholders, build relationships, and make positive political decisions. Transforming adversaries into stakeholders is a key leadership skill.

18 From Good to Great James Collins Slide #18
Moving from Good to Great requires several skills

19 Slide #19 Building great organizations requires identifying the so called “level 5” leaders who combine humility with professional will to create new vision and programs for the organization.

20 From Good to Great Level 5 Leadership Level 5 Leaders have: No ego
No self-interest Humility Professional will and unwavering resolve Fanatically driven, infected with an incurable need to produce sustained results Diligence (plow horse rather than a show horse) When things go wrong they look in the mirror and blame themselves Success is credited to others Slide #20 Level 5 Leaders have: No ego No self-interest Humility Professional will and unwavering resolve Level 5 leaders are: Fanatically driven, infected with an incurable need to produce sustained results Diligent (they are a plow horse rather than a show horse) When things go wrong, Level 5 leaders look in the mirror and blame themselves and their success is credited to others.

21 Mode of Operation Sustaining Disruptive Personal computers Cell phone
Microwave oven Airline travel Slide #21 Organizations operate either into sustaining mode or are engaged in disruptive change. For example, new companies started and then took over significant market share from established companies because they sponsored disruptive technology such as the personal computer, cell phone, microwave oven, and airline travel. Companies that were in mainframe computers, land line phones, slow ovens, and travel by rails lost market share or had to change drastically to stay in business. Leadership should focus on the next disruptive challenge in their field.

22 Disruptive Mid-level providers ART Implants Bio-regeneration
Evidence-based dentistry Online classes Individual insurance Slide #22 Some disruptive challenges in dentistry include: Mid-level providers Atraumatic Restorative Therapy Implants Bio-regeneration Evidence-based dentistry Online classes Individual insurance

23 Leadership Pitfalls Not communicating directly and clearly the plan for change Not defining realistic results and adhering to them Telling people what to do Time management Organizational culture Slide #23 Leaders fail when they do not communicate directly and clearly their plans for change; fail to define realistic results and adhere to them; and fail to understand that leadership is not about telling people what to do. Leaders must be excellent in time management. They also must understand the organizational culture they are working under.

24 Organizational Change
Slide #24 Managing organizational change is a key focus for leaders.

25 Change (Fishman. Fast Company April-May 1997;64-73.)
You cannot change an organization without changing yourself. In any change effort, the first person to change is you. Slide #25 Leaders must accept that in any change effort, the first person to change is the leader.

26 Choosing Strategy for Change (Kotter JP, Schlesinger LA
Choosing Strategy for Change (Kotter JP, Schlesinger LA. HBR March-April 1979) It must be considered that there is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things. Machiavelli, The Prince Slide #26 Change is difficult. Machiavelli stated in The Prince that, “It must be considered that there is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things.”

27 Choosing Strategy for Change (Kotter JP, Schlesinger LA
Choosing Strategy for Change (Kotter JP, Schlesinger LA. HBR March-April 1979) An acceleration of the rate of change will result in an increasing need for reorganization. Reorganization is usually feared because it means disturbing the status quo, a threat to people’s vested interests in their jobs, and an upset to established ways of doing things. For these reasons, needed reorganization is often deferred, with a resulting loss in effectiveness and an increase in costs. Slide #27 An acceleration of the rate of change in an organization will result in an increasing need for reorganization. Reorganization is usually feared, because it means disturbing the status quo, a threat to people’s vested interests in their jobs, and an upset to established ways of doing things. For these reasons, needed reorganization is often deferred, with a resulting loss in effectiveness and an increase in costs.

28 Choosing Strategy for Change (Kotter JP, Schlesinger LA
Choosing Strategy for Change (Kotter JP, Schlesinger LA. HBR March-April 1979) Diagnosing resistance All people experience emotional turmoil Four reasons Desire not to lose something of value Misunderstanding of the change and its implications Belief that the change does not make sense for the organization Low tolerance for change Slide #28 Resistance to change is a major problem in organizations. All people experience emotional turmoil when change is considered. They feel that they will lose something of value; misunderstand the change and its implications; believe that the change does not make sense for the organization and have low tolerance for change.

29 Choosing Strategy for Change (Kotter JP, Schlesinger LA
Choosing Strategy for Change (Kotter JP, Schlesinger LA. HBR March-April 1979) Dealing with resistance Education and communication Participation and involvement Facilitation and support Negotiation and agreement Manipulation and co-optation Explicit or implicit coercion Slide #29 To deal with the resistance to change, leaders can use education and communication; participation and involvement; facilitation and support; negotiation and agreement; manipulation and co-optation; and explicit or implicit coercion.

30 Change requires Chaos A former 3M CEO ordered a young employee named Richard Drew to abandon a project that the CEO insisted would never work. Drew disregarded the order and went on to invent masking tape, one of 3M’s breakthrough products. Drew’s perseverance also laid the foundation form 3M’s defining product: Scotch tape. Slide #30 Change is a process that may lead to surprises. Leaders must persevere. An example of perseverance is detailed in the story of masking tape. A former 3M CEO ordered a young employee named Richard Drew to abandon a project that the CEO insisted would never work. Drew disregarded the order and went on to invent masking tape, one of 3M’s breakthrough products. Drew’s perseverance also laid the foundation form 3M’s defining product: Scotch tape.

31 Change is a Process Defining change as a process has a major advantage in implementing any change plan. Single change acts tend to fail and, hence, lead to skepticism. A process of change by contract portrays a journey with certainties and uncertainties, benefits and risks, and successes and setbacks. Slide #31 Defining change as a process has a major advantage in implementing any change plan. Single change acts tend to fail and, hence, lead to skepticism. A process of change by contract portrays a journey with certainties and uncertainties, benefits and risks, and successes and setbacks.

32 Change and Personal Gain
You cannot change others unless they benefit from the change. Slide #32 Another dictum is that leaders must define how people will benefit from the change.

33 Organizational Culture
Slide #33 Change is rooted in the type of organizational culture that directs the daily activities of employees. It defines their expectations and their daily norms.

34 Slide 34 is deleted

35 It is about culture Leaders don’t create value; they create the culture, competencies, and organizational practices that produce value. Leaders are biased towards types of leadership and typically employ practices that reflect their bias, not necessarily the needs of the situation. HOW your organization operates determines WHAT it creates. Initiatives often need to be managed differently depending on the requirements of each stage. Every leader needs to develop multi-tasking skills because they must add value in a variety of situations contiguously. Every leader needs to surround themselves with colleagues who have diverse perspectives. Slide #35 Leaders don’t create value; they create the culture, competencies, and organizational practices that produce value. Leaders are biased towards types of leadership and typically employ practices that reflect their bias, not necessarily the needs of the situation. HOW your organization operates determines WHAT it creates. Initiatives often need to be managed differently depending on the requirements of each stage. Every leader needs to develop multi-tasking skills because they must add value in a variety of situations contiguously. Every leader needs to surround themselves with colleagues who have diverse perspectives.

36 Implementing Change (HBR April 1991;1-12)
Ten Commandments Analyze the organization and its need for change Create a shared vision and common direction Separate from the past Create a sense of urgency Support a strong leader role Line up political sponsorship Craft an implementation plan Develop enabling structures Communicate, involve people, and be honest Reinforce and institutionalize change Slide #36 The ten commandments for leadership are: Analyze the organization and its need for change Create a shared vision and common direction Separate from the past Create a sense of urgency Support a strong leader role Line up political sponsorship Craft an implementation plan Develop enabling structures Communicate, involve people, and be honest Reinforce and institutionalize change

37 Organizational Change
G Identify any significant changes or developments in the organization’s external environment by examining customer expectations, competitor strengths, best- in-class peers, and industry trends. O Conduct a preliminary analysis of the organization’s internal environment in terms of its capabilities, competencies, and weaknesses. D Determine whether change is necessary and, if so, estimate the level and degree of change required. J Share data on the organization’s environments with key internal stakeholders to acquire their perspectives, promote understanding, assess their support, and build a sense of urgency for change. Q Assemble a diverse committee whose members are powerful, credible, and willing to work together to define and lead organizational change. A Conduct a thorough assessment of the organization’s resources and design, including its strategies, structures, systems, and culture. L Develop a shared vision for change that is clear, challenging, feasible, and universally appealing. N Develop a general strategy for attaining the vision for change that identifies the major initiatives, themes, or priorities. C Communicate the vision and strategy for change, build consensus, and model desired behaviors. Slide #37 This and the next slide list the best order for leading organizational change. The first seven steps prepare the organization to develop a shared vision, followed by developing strategies for attaining the vision for change and communicating it.

38 Organizational Change
F Direct corporate resources to support the attainment of the vision by aligning structures, systems, and policies; establishing mechanisms for integration and feedback; providing training; and dealing with resistance. P Within units, establish specific objectives that will promote quick wins and move the organization toward its vision. H Identify and implement nontraditional processes, new ways of managing, or technical innovations to attain unit-level objectives. K Monitor the implementation process and encourage feedback from managers and employees on what is and is not working. E Refine the implementation process, keep people informed of the progress made by units, and visibly recognize and reward those who exemplify desired behaviors and contribute to the attainment of objectives. M Sustain and expand the use of processes, practices, and technologies that contribute most to unit-level improvements through training, communicating, and appropriate adjustments to structures, systems, and policies. B Evaluate the organizational change process to ascertain whether it produced the desired results and to document the lessons learned. I Establish mechanisms to maintain the gains realized from the organizational change process and to promote future learning and adaptation. Slide #38 The next steps involve directing resources; defining specific objectives for each unit; developing and defining new management approaches; monitoring the implementation process and encouraging feedback; refining the implementation process; sustaining and expanding the use of processes, practices and technologies that contribute to improvements; evaluating the change process; and establishing mechanisms to maintain the gains.


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