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Think about the best leaders you know. Are you inspired by their work ethic and leadership abilities or are you intimidated by their behavior? Are you more likely to go the extra mile for the leader that appreciates you and your abilities or the one who tries to intimidate you into better performance? Leadership is managing multiple priorities while creating a vision for the future, inspiring employees to be their best while enhancing their morale in a stressful workplace and managing internal and external relationships and expectations, all while achieving the organization’s goals of quality patient care in an environment of challenge and cost constraints. And, don’t confuse a management title with leadership...a title does not guarantee that your employees will follow you!

Cancer program administrators are facing a complex healthcare environment that requires a sophisticated level of knowledge related to both the clinical and business aspects of cancer care. Without committed and focused employees, success will never be achieved as no single individual can accomplish everything needed to deliver quality patient care and optimal outcomes. The opportunity for innovation and transformation comes when employees feel safe enough to actively participate in the management of both patients and the cancer program. In working with multiple programs over the years, The Oncology Group consultants have seen programs prosper when employees are an integral part of the management of the program, even if the named administrator is not the strongest. We’ve also seen programs fail miserably when an experienced and knowledgeable administrator is not a leader!

Can administrators enhance their leadership skills? Of course! Leadership is often defined as the ability to encourage staff to accomplish goals, even those that are not pleasant. Cancer program administrators who are only focused on tasks will create an environment that removes their ability to inspire others and ultimately failure will result. Take time to meditate on your management style. Are you making choices that reflect your values and the vision for your program? Are you treating your employees with respect? Are you engaging your employees in the decision-making process in your cancer program? Have you taken the time to identify your strengths and weaknesses? Do you keep your promises to your employees? Are you modeling the behaviors that you hope your employees emulate? These are just a few of the questions that you need to ask yourself as you begin to determine if you are the leader your employees deserve.

In the chapter "Workplace Reengineering, Reorganization, and Redesign" from Nursing Management: Principles and Practice1, written by this author, it states that leadership is necessary to effect change in an organization, but it takes a strong manager to challenge the status quo and innovate. In the popular guide to change, Who Moved My Cheese, a line in the book stated, "I keep doing the same things over and over again and wonder why things don't get better".2 Becoming a leader requires learning new skills and transforming thought processes to move from an intimidating approach to a collegial approach to effect change and accomplish goals. Establishing a culture of trust is the first step in becoming a leader.

You owe it to your employees to fight for what they need to accomplish the facility’s vision for the cancer program, but you also need to make the hard, and sometimes unpopular, decisions. Employees must trust that you have the best interest of the patient in mind as you make decisions. They also need to trust that you are making the right decisions for the success of the program. Establishing trust with employees, physicians and other managers within the organization is critical. Trust results in a caring and collaborative partnership that can develop enhanced communications, creativity and contribute to success in a cancer program. Keeping employees informed is the first step in establishing and validating trust.

From the old adage that there is "no 'I' in team", comes a true sense of synergy between team members, regardless of title and rank. We’ve all seen employees emerge as leaders within their work group, even to the detriment of the named administrator. By identifying and involving employee leaders in a positive manner, their impact in the workplace can be positive rather than negative. The Oncology Group consultants have provided transformational leadership training programs that enable all management and employee levels to embrace change and transform their work environment. The program administrator must be the change agent in the cancer program to accomplish the vision and stated goals of both the facility and the cancer program.

For example, if the goal is to improve patient satisfaction, an education program for staff may be needed. Employees should be asked what they believe will improve patient satisfaction. In one program, employees believed that they should introduce themselves upon entering the room, explain their role and always ask if there is anything else the patient needs before departing. In another instance, the appearance of the staff had become less than professional. By allowing the staff to address the process with an external facilitator, new dress code guidelines were developed that everyone could agree to follow. Allowing the team to make decisions in a targeted focus group and using an external facilitator if the topic is particularly contentious may deliver a much more viable outcome than a top-down decision by an administrator. Staff understanding and acceptance in advance of a change will prevent sabotage…understanding why change is occurring and participating in the decision-making process is a better strategy than an arbitrary management pronouncement!

Communicate! Communicate! Communicate! The more discussion between the cancer program administrator and the staff, the greater the cooperation to effect changes. A leader communicates current status and future goals with everyone who touches the cancer patient at any point in their disease process. The leader rarely keeps secrets but rather feels that the more everyone is engaged in the process of care, the greater the potential for success. Transparency is important to achieve goals and appropriate communication contributes to goal attainment.

Change within a healthcare organization is inevitable given the dynamics of the environment and administrators must be prepared with an appropriate leadership strategy. A coaching style of management, often seen in those administrators perceived as leaders, engages the employees in an empowered, shared governance approach to accomplish meaningful work. Think of the legendary football coaches who inspired their teams to greatness, and draw from their example. You will succeed in inspiring your staff to achievements far greater than if you just manage by mandate and intimidation. Encourage a shared governance model where staff take increasing responsibility for their actions, and they will become engaged and are more willing to do what it takes to achieve success in their workplace.

Leaders empower their teams to effect change by working together toward a common goal...that of quality oncology patient care in an organized cancer program. To learn more about developing an empowered workforce and enhancing your leadership abilities, please contact Marsha Fountain, President of The Oncology Group, at 512.583.8815 or by email at [email protected].