NURSING ESSAY: Leadership Models for Health Care Managers

Introduction.................................................................................................................. Table of Contents

Overview of leadership.................................................................................................

Leaders and leadership and Management&&&&&&&&&&................................

Theoretical Framework.................................................................................................

Definition of Leadership.........................................................................................................

Leadership Development&&&&&&&&&&&.........................................................

Leadership Theories&.&&&&&&&&&&&&&&&&........................................

Leadership Theories Prior to the 1980s...............................................................................

Leadership Theories after the 1980s&&&&&&&&&&&&&................................

Similarities between Bass (1985) and Buns (1978).............................................................

Differences between Bass (1985) and Burns (1978)............................................................

The full range of leadership.................................................................................................

Styles of Leadership&&&&&&&&&&&.................................................................

Laissez-Faire Leadership......................................................................................................

Transactional Leadership&&&&&&&..........................................................................

Transformational Leadership&&........................................................................................

Leadership Styles Variations and Culture............................................................................

The Characteristics of Good Leader.....................................................................................

Leadership Researches in Healthcare Organisations....................................................

Leaders and leadership in the healthcare sectors.........................................................

Innovation& &&&&&&&&&&&&&&&&&&&&&&&&&&&&&... The Role of Transformational leadership in Creating Creativity and Organizational

Transformational Leadership Style and Charisma..................................................................

Leadership Styles and Gender in the Arab World...................................................................

Women in the Arab world.......................................................................................................

Tools and measurements used for the identification of (TTL)&&&&.&&.....................

Transformational leadership scales..........................................................................................

Transactional leadership scales

Outcome criteria which are included in the MLQ....................................................................

The Integration between Leadership and the Quality of Health Services...............................

History of Quality in Healthcare&&&&&......................................................................

Jordan&&&&&&&&.............................................................................................

The Problem of Leaders and leadership in Jordan.........................................................

The Context of Healthcare in Jordan........................................................................................

Jordanian Ministry of Health Hierarchy...................................................................................

Jordan Hospitals&&&&........................................................................................................

Jordan Hospitals by Governorate..............................................................................................

The Recent Issues of Health System in Jordan.........................................................................

The Health System Reforms (Jordan).......................................................................................

Health System Challenges........................................................................................................

Strategic Plan for the Ministry of Health- Jordan &&&&&&&&&&&&&...........

Analysis of the current situation&&&&&&&&&&&&&........................................

Deficiencies in MOH................................................................................................................

Threats&&&&&&&&&&...............................................................................................

-

1. Introduction This book provides an overview of leadership and leader work in general, detailing the most important roles, skills, challenges, abilities and goals that a nursing leader needs to employ to be successful. The first chapter details the context of healthcare. This is followed by an overview of the literature of health service leadership, describing the similarities and differences between health service leadership and its more generalised leader counterpart. Later, this book provides a review of studies and articles written about hospital leadership. Moreover, the book elucidates the role, skills, challenges and educational needs of health service leaders, while the last chapter summarises this book.

The present book aims to understand the nature of the head nurses leadership styles and to evaluate their perceptions of their most important roles, skills and training courses. Also, this book aims to recognise the challenges, obstacles and problems facing head nurses and to examine the degree of their impact on health outcomes.

There is an extensive body of literature charting the advanced modifications in the work of nursing leaders. Other areas of interest have included descriptions of how nursing leader work is perceived in both local and global contexts. Studies have compared nursing leaders to more traditional leaders, highlighting important yet subtle differences between them, such as the uniqueness of the nursing leader’s roles in dealing with the staff nurses and patients.

The healthcare field has changed dramatically in the past few years. Nursing leaders have had to respond to new technology, new organisational goals and new challenges. The most effective leaders have responded to the dynamism of the

-

healthcare field by altering their leading skill set. Not only does this book clarify many components of the role of nursing leaders in this climate, but it also highlights differences in opinion between various researchers as to the requirements of such a unique job.

The author searched national, regional and international sources, using the University of New England (UNE) library catalogue, National Library of Medicine (NLM) catalogue and electronic library resources, in addition to several governmental reports and statistics. Keywords and phrases used were: nursing leaders, head nurse manager, nursing leadership, health leader, health leadership, leader functions, leader roles, managerial skills, hospital, healthcare system, job motivation, health policy, qualification needs, professional development, and challenges facing hospital leaders. Meta Search and Google Scholar were used to search for electronic sources, largely through collections such as Journal Storage (JSTOR), ProQuest, PubMed and Emerald. Additional literature was obtained from reference lists in the reviewed books and journal articles. 2. Leadership 2 Overview of Leadership In recent years leadership, has become one of the most fundamental and influential concepts in the evolution of organisational and management theory. There is an increased awareness of issues associated with quality leaders and leadership practices. It is widely believed that leaders wish to achieve success and reach personal, professional and organisational goals and objectives (Pointer, 2005; Pomey, Denis, Baker, Préval, & Macintosh-Murray 2008; Goleman, Boyatzis & McKee, 2002).

-

manager that his position is formal in the organisation with several roles of which is leadership. Other roles of manager include information processing, decision making and visioning which can be translated into real results through leadership (Shortell and Kaluzny, 2000). Another difference between leaders and managers was shown to be that leaders are more interesting by commitment while managers only perform position responsibilities and exercise authority (Yukl, 2006). Others see managerial activities that include intrapersonal skills such as regulating one9s emotions and accommodating to authority, interpersonal skills such as building and maintaining relationships, business skills such as planning, budgeting and coordinating, and leaders and leadership skills such as building and motivating a high- performing team (Hogan and Kaiser, 2005).

2 Theoretical Framework This conceptual framework identifies a full range of leaders and leadership characteristics or styles, which incorporates transformational, transactional, and laissez-faire leaders and leadership styles. It consists of elements or factors that represent the leaders and leadership9s attributes or behaviours. First, transformational leaders and leadership are concerned with the performance and development of followers to their fullest potential. It consists of five factors; Idealized Influence or Charisma (Attributed or Behaviours), Inspirational Motivation, Intellectual Stimulation, and Individualised Consideration (Bass & Avolio, 1990). Second, transactional leaders and leadership are concerned with the exchange of things of value between the leaders and leadership and the followers to advance leaders and the leadership and followers9 agenda (Northhouse, 1997). According to Bass (1985), the leaders and leadership rewards or disciplines the followers depending

-

on the adequacy of the followers9 performance. Transactional leaders and leadership consist of three factors; Contingent Reward, Management by Exception-Active, and Management by Exception-Passive. Third, laissez-faire is the most inactive style and represents the avoidance and absence of assertive leaders and leadership. Bass (1985) viewed the transformational and transactional leaders and leadership constructs as complementary constructs. Bass later developed the Multifactor Leadership Questionnaire (MLQ) to assess different leaders and leadership styles. The evolution of this conceptual model will be discussed further later in this book. Figure 4 shows the full-range of leaders and leadership characteristics and styles. Leaders and the Leadership phenomenon as described by many are known to be important in influencing the behaviour of individual employees and therefore, the effectiveness of organisations. Transformational leaders with its particular leadership characteristics have proven to be particularly popular and widely studied because it is widely regarded to be important to modern work and modern organisations (Lim & Ployhart, 2004). In modern organisations positions and responsibilities are less static and more open-ended, and the familiar boundaries distinguished upper, middle and lower level leaders and leaderships are being redrawn. In the past, the emphasis has been on how leaders and an organisations9 leadership oversee the work of people and departments (Jooste, 2004). Presently, the emphasis is on how leaders and followers interact to accomplish a common organisational goal. Assessing current leaders and organisational leadership is an important step in addressing the needs of the future. 2 Definition of Leadership Burns (1978 p) claims that <leaders and leadership is one of the most observed and least understood phenomena on the earth.= An interest in the concepts of

-1-

Northhouse (1997) argues that despite the different ways that leaders and leadership have been conceptualised; there are four components that can be identified as central to the phenomenon of leaders and leadership. These components are that leaders and leadership: (1) is a process; (2) it involves an influence on the followers, (3) occurs within a group context, and (4) involves goal achievement. Based on the components, Northhouse (1997) suggests the following definition <Leaders and Leadership is a process whereby an individual influences a group of individuals to achieve a common goal=.

Bass (1990) in his Handbook of Leaders and leadership argues that <leaders and leadership has been conceived as the focus of group processes, as a matter of personality, as a matter of including compliance, as the exercise of influence, as particular behaviours, as a form of persuasion, as a power relation, as an instrument to achieve goals, as an effect of interaction, as a differentiated role, as initiation of structure, and as many combinations of these definitions.=

Both Bass (1985) and Burn (1978) define leaders and leadership as a transformative process through which leaders and leadership create visions of a future state for the organisation and articulates new ways for the followers to accomplish organisational goals. Although there are many differences in the definitions of leaders and leadership, the commonality has to do with the presence of a group, a phenomenon where there is an interaction between two or more people. Most researchers define leaders and leadership in a manner appropriate to their investigation, so it is necessary to be familiar with a variety of perspectives from theorists and researchers and to accept leaders and leadership as a complex and multifaceted phenomenon (Marriner-Tomey 1993).

—

The Australian Leaders and Leadership Development Centre define leaders and leadership as any behaviour that influences the actions and attitudes of others to achieve certain results. Leaders and leadership are neither inherently good nor bad. This depends on the results being pursued and the means used to influence others (Killian 2007).

The literature shows the involvement of several elements in defining leaders and leadership. These elements included individual traits, leaders and leadership behaviour, interaction patterns, role relationships, follower perceptions, influence over followers, influence on task goals and influence on organisational culture. The concept of influence is the skeleton for many of these definitions (Yukl, 2006). One of the leader and leadership definitions adopted by Stogdill, (1974) describes “a process of influencing the activities of an organised group in its efforts toward setting and achieving goals=.

Munson (1921) defined leaders and leadership as: “The creative and directive force of morale.” Then it was defined by Bennis (1959) as: “The process by which an agent induces a subordinate to behave in a desired manner.” According to Hollander & Julian (1969), the influence or effect was introduced into the definition of leaders and leadership to be: “The presence of a particular influence relationship between two or more persons.” Fielder (1967) defined leaders and leadership as Directing and coordinating the work of group members. Leaders and leadership were also defined by Merton (1969) as an interpersonal relation in whom others comply because they want to, not because they have to.

—

theories were known as the 8great man9 theories because they were based on the attributes of great social, political and military leaders (Northhouse 1997).

The trait approach focuses exclusively on the leader, and not on the followers or the situation. Major leadership traits that were derived from the research during that period include intelligence, self-confidence, determination, integrity, and sociability. It was believed that people were born with these traits and that only great people possessed these traits. The early work of Stogdill (1948) contributes to this traits approach.

During the 1950s, the emphasis in leadership theory development changed from analysing traits to identifying behaviours which resulted in effective leadership (Cole, 1999). This behaviour-centered approach, known as the style approach, attempts to determine what successful leaders do and how they act. The style approach provides a framework for assessing leadership in a broad way, as behaviour with a task and relationship dimension. The main purpose of the style approach is to determine how leaders combine the two types of behaviours; task behaviours and relation behaviours, to influence subordinates in their efforts to reach a goal (Northhouse 1997).

The leader behaviour description questionnaire (LBDQ) done at the Ohio State University and studies done at the University of Michigan have had the most impact on this approach. These studies explored the relationship between two variables: people and task. They reported that supervisors of highly productive groups tended to be employee-oriented, allowing employees participation in decision making, and promoted team development and cohesiveness. On the other hand, supervisors with

—

low producing groups were task-oriented, focused more on tasks than employees need, and monitored and controlled employees9 performance (Murphy, 2005).

The situational approach was created when researchers found that traits and behaviours could not fully explain leadership effectiveness, and at the same time, it became apparent that behaviours in one circumstance did not produce the same effect in another circumstance (Darr, Longest & Rakich, 1985). The situational approach was developed by Hersey and Blanchard (1993) and has been revised several times since its inception. The underlying idea of the situational theory is that different situations require different kinds of leadership. Northhouse (1997) suggests that leadership is comprised of both a directive and supportive dimension. The level of leadership required is contextually informed.

In response to Stogdill (1948) approach that focused on the interaction of leadership traits, the leaders9 behaviours and the situation in which the leader exists; Fielder (1967) introduced the contingency approach that proposed that leadership effectiveness be determined by the interaction between the leader9s behaviour and the situation. Northhouse (1997) developed upon Fielder9s approach to include leaders traits, behaviours, and the situation. According to Horner (1997), this contingency approach makes the assumption that the effects of a variable on leadership are contingent on other variables, and that leadership could be different in every situation. Contingency theory developed into the path-goal theory, which deals with how leaders motivate, and the leader-member exchange theory, which centres on the interaction between leaders and followers.

—

hand, is the degree to which a leader defines and structures his or her own role and the role of the subordinate toward attainment of organisational outcomes.

Since the early 1980s, a new paradigm of leadership emerged as a result of the perception of high levels of organisational effectiveness associated with transformational leadership in generating followers9 willingness to exert extra effort, commitment, satisfaction and contribution (Bass 1985). Bass9s new model was enlarged with a full range of leadership strategies and behaviours, which incorporates transformational, transactional, and laissez-faire leadership. According to Koene et al. (2002), the full range leadership adds to the early leadership concepts by introducing the visionary aspects of leadership as well as emotional involvement to employees within the organisation.

Figure 1: styles of leaderships Source: Adapted from Leadership Theory and Practice. Northhouse (1997) Transformational leadership is concerned with the performance and development of teams to their fullest potential. Figure 2 shows a diagrammatical representation of this level. Transformational leadership consists of five factors; Idealized Influence (Attributed), Idealized Influence (Behaviours), Inspirational Motivation, Intellectual Stimulation, and Individualised Consideration (Bass &

—

Avolio, 1990). Transformational leadership has proven to be particularly popular and widely studied because it has appeared to be extremely important to modern work and modern organisations (Lim & Ployhart, 2004). This concept has evolved over time and usually involves various levels of intervention or involvement between the leader and team.

Figure 2: Diagrammatical summary of the components of transformational leadership. Source: Adapted from Leadership Theory and Practice. (Northhouse 1997) The second level, transactional leadership is concerned with the exchange of things of value between the leader and their team to advance their agreed agenda (Northhouse, 1997). According to Bass (1985), the leader rewards or disciplines the followers depending on the adequacy of the followers9 performance. Transactional leadership consists of three factors; Contingent Reward, Management by Exception- Active, and Management by Exception-Passive.

—

Figure 4: Bass models of full range of transformational, transaction and laissez faire leadership. Source: Adapted from Leadership Theory and Practice (Northhouse 1997).

2.6 Similarities between Bass (1985) and Buns (1978) Bass (1985) expanded the work of Burns (1978) and House (1977). Bass9s (1985) definition of transformational leadership has several similarities to Burns9s (1978) in several aspects. First, both observe the transformational leaders attempt to raise the needs of the team and promote changes in the individuals, groups, and organisational performance. Secondly, both depend on Maslow9s (1954) Hierarchy of Needs in their models to explain the relationship between the transformational leadership and the follower9s motivational bases. According to Bass (1985), the task of the leader is to motivate people in the organisation to achieve their goal, make the extra effort, and work beyond expectation. The leaders9 intent is to transform the

-1-

teams9 needs from a lower level to a higher order level. Burns (1978) considers Maslow9s hierarchy of needs fundamental to the transformational process. Both theorists consider the elevation of need level in transformational leadership as a moral process. For example, employees would require a job description, an office space and equipment to perform their tasks prior to being involved in career counselling or committing to team interests or organisational performance.

2.6 Differences between Bass (1985) and Burns (1978) Bass9s (1985) model differs from Burns9s (1978) model in three respects. Bass added the expansion of the teams9 needs and wanted. He suggests that transactional leaders attempt to satisfy the current needs of their staff through the exchange process. For instance, leaders can bestow salary or promotion as a reward for work. Secondly, Burns views transformational leadership as entailing a moral imperative that is necessary to elevate what was good rather than evil for the person. Thirdly, transactional and transformational leadership are viewed differently. Transformational leadership is on opposite ends of a continuum model of transactional leadership. One type excludes the other, and the person is either transformational or transactional. In contrast Bass (1985) argues that the individuals can display both transformational and transactional leadership qualities and that the transformational leadership is not effective if it exists without transactional leadership (Bass, 1985).

2.6 The full range of leadership Bass9s theory is considered a full range leadership theory. (Fig) This full range of leadership incorporates transformational, transactional and laissez-faire leadership. Bass extended House9s (1977) work on charisma by giving more attention
Download
Save
Share

This is a preview
Do you want full access? Go Premium and unlock all 114 pages

Access to all documents

Download Documents

Questions to our Experts New

Free Trial

Try free Premium for 30 days

Upload

Share your documents to unlock
Already Premium?
Log in
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

Table of Contents

Introduction……………………………………………………………………………………………………4
Overview of leadership…………………………………………………………………………………….5
Leaders and leadership and Management&&&&&&&&&&…………………………..6
Theoretical Framework…………………………………………………………………………………….7
Definition of Leadership……………………………………………………………………………………………8
Leadership Development&&&&&&&&&&&………………………………………………… 12
Leadership Theories&.&&&&&&&&&&&&&&&&…………………………………. 12
Leadership Theories Prior to the 1980s……………………………………………………………………. 12
Leadership Theories after the 1980s&&&&&&&&&&&&&………………………….. 15
Similarities between Bass (1985) and Buns (1978)……………………………………………………. 19
Differences between Bass (1985) and Burns (1978)……………………………………………………20
The full range of leadership……………………………………………………………………………………. 20
Styles of Leadership&&&&&&&&&&&……………………………………………………….. 23
Laissez-Faire Leadership………………………………………………………………………………………… 23
Transactional Leadership&&&&&&&………………………………………………………………..24
Transformational Leadership&&……………………………………………………………………………. 27
Leadership Styles Variations and Culture…………………………………………………………………. 31
The Characteristics of Good Leader…………………………………………………………………………. 32
Leadership Researches in Healthcare Organisations…………………………………………….33
Leaders and leadership in the healthcare sectors…………………………………………………37
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

The Role of Transformational leadership in Creating Creativity and Organizational
Innovation& &&&&&&&&&&&&&&&&&&&&&&&&&&&&&… 46
Transformational Leadership Style and Charisma………………………………………………………… 52
Leadership Styles and Gender in the Arab World…………………………………………………………. 53
Women in the Arab world…………………………………………………………………………………………. 54
Tools and measurements used for the identification of (TTL)&&&&.&&………………… 54
Transformational leadership scales……………………………………………………………………………… 55
Transactional leadership scales ……………………………. …………………………………………………… 56
Outcome criteria which are included in the MLQ…………………………………………………………..56
The Integration between Leadership and the Quality of Health Services…………………………. 57
History of Quality in Healthcare&&&&&……………………………………………………………. 59
Jordan&&&&&&&&………………………………………………………………………………… 60
The Problem of Leaders and leadership in Jordan………………………………………………… 62
The Context of Healthcare in Jordan…………………………………………………………………………….62
Jordanian Ministry of Health Hierarchy………………………………………………………………………..66
Jordan Hospitals&&&&…………………………………………………………………………………………..69
Jordan Hospitals by Governorate………………………………………………………………………………….70
The Recent Issues of Health System in Jordan……………………………………………………………….73
The Health System Reforms (Jordan)……………………………………………………………………………75
Health System Challenges…………………………………………………………………………………………..76
Strategic Plan for the Ministry of Health- Jordan &&&&&&&&&&&&&………..77
Analysis of the current situation&&&&&&&&&&&&&………………………………….79
Deficiencies in MOH………………………………………………………………………………………………….79
Threats&&&&&&&&&&…………………………………………………………………………………..80
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

Why is this page out of focus?
This is a Premium document. Become Premium to read the whole document.
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

1. Introduction
   This book provides an overview of leadership and leader work in general,
   detailing the most important roles, skills, challenges, abilities and goals that a nursing
   leader needs to employ to be successful. The first chapter details the context of
   healthcare. This is followed by an overview of the literature of health service
   leadership, describing the similarities and differences between health service
   leadership and its more generalised leader counterpart. Later, this book provides a
   review of studies and articles written about hospital leadership. Moreover, the book
   elucidates the role, skills, challenges and educational needs of health service leaders,
   while the last chapter summarises this book.
   The present book aims to understand the nature of the head nurses leadership
   styles and to evaluate their perceptions of their most important roles, skills and
   training courses. Also, this book aims to recognise the challenges, obstacles and
   problems facing head nurses and to examine the degree of their impact on health
   outcomes.
   There is an extensive body of literature charting the advanced modifications in
   the work of nursing leaders. Other areas of interest have included descriptions of how
   nursing leader work is perceived in both local and global contexts. Studies have
   compared nursing leaders to more traditional leaders, highlighting important yet
   subtle differences between them, such as the uniqueness of the nursing leader’s roles
   in dealing with the staff nurses and patients.
   The healthcare field has changed dramatically in the past few years. Nursing
   leaders have had to respond to new technology, new organisational goals and new
   challenges. The most effective leaders have responded to the dynamism of the
   Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

healthcare field by altering their leading skill set. Not only does this book clarify
many components of the role of nursing leaders in this climate, but it also highlights
differences in opinion between various researchers as to the requirements of such a
unique job.
The author searched national, regional and international sources, using the
University of New England (UNE) library catalogue, National Library of Medicine
(NLM) catalogue and electronic library resources, in addition to several governmental
reports and statistics. Keywords and phrases used were: nursing leaders, head nurse
manager, nursing leadership, health leader, health leadership, leader functions, leader
roles, managerial skills, hospital, healthcare system, job motivation, health policy,
qualification needs, professional development, and challenges facing hospital leaders.
Meta Search and Google Scholar were used to search for electronic sources, largely
through collections such as Journal Storage (JSTOR), ProQuest, PubMed and
Emerald. Additional literature was obtained from reference lists in the reviewed books
and journal articles.

2. Leadership
   2.1 Overview of Leadership
   In recent years leadership, has become one of the most fundamental and
   influential concepts in the evolution of organisational and management theory. There
   is an increased awareness of issues associated with quality leaders and leadership
   practices. It is widely believed that leaders wish to achieve success and reach
   personal, professional and organisational goals and objectives (Pointer, 2005; Pomey,
   Denis, Baker, Préval, & Macintosh-Murray 2008; Goleman, Boyatzis & McKee,
   2002).
   Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

People in general and leaders, in particular, tend to possess inherently and then
learn certain leadership characteristics and abilities to cope with challenges that may
arise in various contexts throughout life, assisting them in successfully overcoming
challenges and obstacles. Consequently, individuals and organisations without well
developed, appropriate leadership qualities will most often face insurmountable
challenges and career stagnation (Pomey et al. 2008).
Taking into consideration, the wide acceptance of the concept that leaders are
made, researchers, in the field, have developed certain tools and measurements
associated with styles of leaders and leadership including some of the specific
behavioural traits and characteristics associated with good leaders and leaderships
(Burns, 1978).
Leader and leadership, therefore, are commonly conceptualised within
behavioural domains with a wide variety of names and characteristics. In the past, the
emphasis was mainly put on how leaders oversee the work of people within fixed
units (Jooste, 2004). Nowadays, leaders and leadership studies focus on results or
effectiveness, or how leaders and the leadership and their team interact to accomplish
organisational goals. Assessing current leaders and their leadership experience in an
organisation is an important step in addressing the governance and management needs
of the future (Jooste, 2004). Therefore, this study is being conducted to fully explore
leaders and leadership styles in the health system (MOH) in Jordan, an Islamic
country with a modern organisational healthcare system as well as private hospitals.
2.2 Leaders and Leadership and Management
In an attempt to differentiate between the concept of management and
leadership, Shortell and Kaluzny (2000) showed that a management runs by a
Why is this page out of focus?
This is a Premium document. Become Premium to read the whole document.
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

manager that his position is formal in the organisation with several roles of which is
leadership. Other roles of manager include information processing, decision making
and visioning which can be translated into real results through leadership (Shortell
and Kaluzny, 2000). Another difference between leaders and managers was shown to
be that leaders are more interesting by commitment while managers only perform
position responsibilities and exercise authority (Yukl, 2006).
Others see managerial activities that include intrapersonal skills such as regulating
one9s emotions and accommodating to authority, interpersonal skills such as building
and maintaining relationships, business skills such as planning, budgeting and
coordinating, and leaders and leadership skills such as building and motivating a high-
performing team (Hogan and Kaiser, 2005).
2.3 Theoretical Framework
This conceptual framework identifies a full range of leaders and leadership
characteristics or styles, which incorporates transformational, transactional, and
laissez-faire leaders and leadership styles. It consists of elements or factors that
represent the leaders and leadership9s attributes or behaviours. First, transformational
leaders and leadership are concerned with the performance and development of
followers to their fullest potential. It consists of five factors; Idealized Influence or
Charisma (Attributed or Behaviours), Inspirational Motivation, Intellectual
Stimulation, and Individualised Consideration (Bass & Avolio, 1990).
Second, transactional leaders and leadership are concerned with the exchange
of things of value between the leaders and leadership and the followers to advance
leaders and the leadership and followers9 agenda (Northhouse, 1997). According to
Bass (1985), the leaders and leadership rewards or disciplines the followers depending
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

on the adequacy of the followers9 performance. Transactional leaders and leadership
consist of three factors; Contingent Reward, Management by Exception-Active, and
Management by Exception-Passive.
Third, laissez-faire is the most inactive style and represents the avoidance and
absence of assertive leaders and leadership. Bass (1985) viewed the transformational
and transactional leaders and leadership constructs as complementary constructs. Bass
later developed the Multifactor Leadership Questionnaire (MLQ) to assess different
leaders and leadership styles. The evolution of this conceptual model will be
discussed further later in this book. Figure 4 shows the full-range of leaders and
leadership characteristics and styles.
Leaders and the Leadership phenomenon as described by many are known to
be important in influencing the behaviour of individual employees and therefore, the
effectiveness of organisations. Transformational leaders with its particular leadership
characteristics have proven to be particularly popular and widely studied because it is
widely regarded to be important to modern work and modern organisations (Lim &
Ployhart, 2004). In modern organisations positions and responsibilities are less static
and more open-ended, and the familiar boundaries distinguished upper, middle and
lower level leaders and leaderships are being redrawn. In the past, the emphasis has
been on how leaders and an organisations9 leadership oversee the work of people and
departments (Jooste, 2004). Presently, the emphasis is on how leaders and followers
interact to accomplish a common organisational goal. Assessing current leaders and
organisational leadership is an important step in addressing the needs of the future.
2.4 Definition of Leadership
Burns (1978 p.2) claims that <leaders and leadership is one of the most
observed and least understood phenomena on the earth.= An interest in the concepts of
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

leaders and leadership is apparent in the literature, and the topic continues to be
heavily investigated in organisational and communication studies. The concept of
leaders and leadership exists in all societies and is essential to the functioning of
organising and organisations within these societies. However, the attributes that are
seen as characteristics of leading may vary across cultures (Ardichvili, 2001). As a
consequence, there is a need for understanding the way leaders and leadership is
perceived and experienced in various cultures.
Leaders and leadership have been described in many different ways, usually
by being contrasted to definitions of management. In the past, leaders and leadership
have been viewed as a form of social influence, but recently it began to be viewed as a
form of organising. Leaders and leadership can be viewed as both a perceptual and
behavioural phenomenon. Finding a single definition of leaders and leadership
appears difficult and fruitless because an appropriate choice of a definition depends
on the theoretical, methodological, and substantive aspects of leaders and leadership
being considered (Vance & Larson, 2002). Marriner-Tomey (1993) found that the
definitions of leadership are often confusing and unclear because of the use of some
terms such as authority, power, management, administration, control, and supervision.
The perception of Bass (1990) for the definition of leaders and leadership has
different views. One definition views leaders and leadership as the focus of group
process, where the leaders and leadership are at the centre of this group activity.
Another definition views leaders and leadership from a personality perspective. This
view focuses on the traits and behaviours of the leaders and leadership. In addition,
leaders and leadership have been defined as a power relationship as well as an
instrument of goal achievement.
Why is this page out of focus?
This is a Premium document. Become Premium to read the whole document.
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

• 1 –

Northhouse (1997) argues that despite the different ways that leaders and
leadership have been conceptualised; there are four components that can be identified
as central to the phenomenon of leaders and leadership. These components are that
leaders and leadership: (1) is a process; (2) it involves an influence on the followers,
(3) occurs within a group context, and (4) involves goal achievement. Based on the
components, Northhouse (1997) suggests the following definition <Leaders and
Leadership is a process whereby an individual influences a group of individuals to
achieve a common goal=.
Bass (1990) in his Handbook of Leaders and leadership argues that <leaders
and leadership has been conceived as the focus of group processes, as a matter of
personality, as a matter of including compliance, as the exercise of influence, as
particular behaviours, as a form of persuasion, as a power relation, as an instrument to
achieve goals, as an effect of interaction, as a differentiated role, as initiation of
structure, and as many combinations of these definitions.=
Both Bass (1985) and Burn (1978) define leaders and leadership as a
transformative process through which leaders and leadership create visions of a future
state for the organisation and articulates new ways for the followers to accomplish
organisational goals. Although there are many differences in the definitions of leaders
and leadership, the commonality has to do with the presence of a group, a
phenomenon where there is an interaction between two or more people. Most
researchers define leaders and leadership in a manner appropriate to their
investigation, so it is necessary to be familiar with a variety of perspectives from
theorists and researchers and to accept leaders and leadership as a complex and
multifaceted phenomenon (Marriner-Tomey 1993).
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

The Australian Leaders and Leadership Development Centre define leaders
and leadership as any behaviour that influences the actions and attitudes of others to
achieve certain results. Leaders and leadership are neither inherently good nor bad.
This depends on the results being pursued and the means used to influence others
(Killian 2007).
The literature shows the involvement of several elements in defining leaders
and leadership. These elements included individual traits, leaders and leadership
behaviour, interaction patterns, role relationships, follower perceptions, influence over
followers, influence on task goals and influence on organisational culture. The
concept of influence is the skeleton for many of these definitions (Yukl, 2006). One of
the leader and leadership definitions adopted by Stogdill, (1974) describes “a process
of influencing the activities of an organised group in its efforts toward setting and
achieving goals=.
Munson (1921) defined leaders and leadership as: “The creative and directive
force of morale.” Then it was defined by Bennis (1959) as: “The process by which an
agent induces a subordinate to behave in a desired manner.” According to Hollander
& Julian (1969), the influence or effect was introduced into the definition of leaders
and leadership to be: “The presence of a particular influence relationship between two
or more persons.” Fielder (1967) defined leaders and leadership as Directing and
coordinating the work of group members. Leaders and leadership were also defined
by Merton (1969) as an interpersonal relation in whom others comply because they
want to, not because they have to.

Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

2.5 Leadership Development
Velsor & Drath (2004) argues that development of leader may be viewed as to
increase a person9s capacity to be effective in leadership roles and processes which
include setting direction, creating alignment and maintaining commitment in groups
of people who share common work (Velsor & Drath, 2004).
In view of leadership context, most people should take on leadership roles and
participate in leadership processes for performing their commitments to larger social
entities such as the organisations in which they work, the social or volunteer groups of
which they are a part, and the professional groups with which they identify. Such
leadership roles can be formal positions infused with authority to take action and
make decisions or informal roles with little official authority. Furthermore, the
development of leadership rotates on the axis of personal development to enhance
leader effectiveness. It has been argued that leadership capacity depends partly on
genetics, early childhood development, and adult experiences (Velsor & Drath, 2004).
In their argument, Hogan and Kaiser (2005) showed that the leadership development
process to start with the development of intrapersonal skills, continue with
interpersonal skills, business skills and end with leadership skills such as building and
motivating high-performance teams (Hogan and Kaiser, 2005). It was argued by
Schön (1991) that the development of adult thought requires experience and
conceptualization, reflection and action.
2.6 Theories of Leadership
2.6.1 Leadership Theories Prior to the 1980s
In the early 1950s, leadership theories focused on the leader9s personal traits,
such as physical, mental, and personality characteristics. Such traits were studied to
determine what made certain people great and effective leaders. Early leadership
Why is this page out of focus?
This is a Premium document. Become Premium to read the whole document.
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

theories were known as the 8great man9 theories because they were based on the
attributes of great social, political and military leaders (Northhouse 1997).
The trait approach focuses exclusively on the leader, and not on the followers
or the situation. Major leadership traits that were derived from the research during that
period include intelligence, self-confidence, determination, integrity, and sociability.
It was believed that people were born with these traits and that only great people
possessed these traits. The early work of Stogdill (1948) contributes to this traits
approach.
During the 1950s, the emphasis in leadership theory development changed
from analysing traits to identifying behaviours which resulted in effective leadership
(Cole, 1999). This behaviour-centered approach, known as the style approach,
attempts to determine what successful leaders do and how they act. The style
approach provides a framework for assessing leadership in a broad way, as behaviour
with a task and relationship dimension. The main purpose of the style approach is to
determine how leaders combine the two types of behaviours; task behaviours and
relation behaviours, to influence subordinates in their efforts to reach a goal
(Northhouse 1997).
The leader behaviour description questionnaire (LBDQ) done at the Ohio State
University and studies done at the University of Michigan have had the most impact
on this approach. These studies explored the relationship between two variables:
people and task. They reported that supervisors of highly productive groups tended to
be employee-oriented, allowing employees participation in decision making, and
promoted team development and cohesiveness. On the other hand, supervisors with
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

low producing groups were task-oriented, focused more on tasks than employees9
need, and monitored and controlled employees9 performance (Murphy, 2005).
The situational approach was created when researchers found that traits and
behaviours could not fully explain leadership effectiveness, and at the same time, it
became apparent that behaviours in one circumstance did not produce the same effect
in another circumstance (Darr, Longest & Rakich, 1985). The situational approach
was developed by Hersey and Blanchard (1993) and has been revised several times
since its inception. The underlying idea of the situational theory is that different
situations require different kinds of leadership. Northhouse (1997) suggests that
leadership is comprised of both a directive and supportive dimension. The level of
leadership required is contextually informed.
In response to Stogdill (1948) approach that focused on the interaction of
leadership traits, the leaders9 behaviours and the situation in which the leader exists;
Fielder (1967) introduced the contingency approach that proposed that leadership
effectiveness be determined by the interaction between the leader9s behaviour and the
situation. Northhouse (1997) developed upon Fielder9s approach to include leaders9
traits, behaviours, and the situation. According to Horner (1997), this contingency
approach makes the assumption that the effects of a variable on leadership are
contingent on other variables, and that leadership could be different in every situation.
Contingency theory developed into the path-goal theory, which deals with how
leaders motivate, and the leader-member exchange theory, which centres on the
interaction between leaders and followers.

Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

2.6.2 Leadership theory after the 1980s
A major shift in understanding leadership developed as a consequence of the
work of political historian MacGregor Burns (1978). Burns research attempts to link
the role of leadership and followership distinguishing between two types of
leadership: transactional and transformational. According to Burns (1978 p 19)
transactional leadership, <occurs when one person takes the initiative in making
contact with others for the purpose of an exchange of valued things.= Burns argues the
transactional leaders9 relationship to followers is based on a mutually beneficial
exchange. In contrast, transformational leadership <occurs when one or more persons
engage with others in such a way that leaders and followers raise one another to
higher levels of motivation and morality= (Burns, 1978 p 20). Burns argues that
transformational leaders influence followers to transcend personal interests and
transform themselves into agents of collective achievement. Concurrently, House,
(1977) analyses the characteristics of historical leaders who elicited extraordinary
levels of devotion and commitment from followers. Chemers, (2000 pp 27-43)
reported that House identified three types of skills that represent charismatic leaders:
personal characteristics, such as high level of self-confidence; behavioural
characteristics, such as goal articulation and role modelling; and finally, situational
influences, such as dealing with high levels of environmental stress.
Koene, Vogelaar and Soeters (2002 pp 193-215) identified consideration and
initiation structure as key leadership qualities. This thinking pervaded leadership
theoretical perspectives until the 19809s. They defined consideration as the degree to
which a leader acts in a friendly and supportive manner, shows concern for the needs
of subordinates and looks out for their well-being. Initiation structure, on the other
Why is this page out of focus?
This is a Premium document. Become Premium to read the whole document.
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

hand, is the degree to which a leader defines and structures his or her own role and the
role of the subordinate toward attainment of organisational outcomes.
Since the early 1980s, a new paradigm of leadership emerged as a result of the
perception of high levels of organisational effectiveness associated with
transformational leadership in generating followers9 willingness to exert extra effort,
commitment, satisfaction and contribution (Bass 1985). Bass9s new model was
enlarged with a full range of leadership strategies and behaviours, which incorporates
transformational, transactional, and laissez-faire leadership. According to Koene et al.
(2002), the full range leadership adds to the early leadership concepts by introducing
the visionary aspects of leadership as well as emotional involvement to employees
within the organisation.

Figure 1: styles of leaderships
Source: Adapted from Leadership Theory and Practice. Northhouse (1997)
Transformational leadership is concerned with the performance and
development of teams to their fullest potential. Figure 2 shows a diagrammatical
representation of this level. Transformational leadership consists of five factors;
Idealized Influence (Attributed), Idealized Influence (Behaviours), Inspirational
Motivation, Intellectual Stimulation, and Individualised Consideration (Bass &
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

Avolio, 1990). Transformational leadership has proven to be particularly popular and
widely studied because it has appeared to be extremely important to modern work and
modern organisations (Lim & Ployhart, 2004). This concept has evolved over time
and usually involves various levels of intervention or involvement between the leader
and team.

Figure 2: Diagrammatical summary of the components of transformational leadership.
Source: Adapted from Leadership Theory and Practice. (Northhouse 1997)
The second level, transactional leadership is concerned with the exchange of
things of value between the leader and their team to advance their agreed agenda
(Northhouse, 1997). According to Bass (1985), the leader rewards or disciplines the
followers depending on the adequacy of the followers9 performance. Transactional
leadership consists of three factors; Contingent Reward, Management by Exception-
Active, and Management by Exception-Passive.
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

Figure 3: Diagrammatical summary of the components of transformational leadership.
Source: Adapted from Leadership Theory and Practice. (Northhouse 1997)
Thirdly, laissez-faire is an inactive style and represents the avoidance and
absence of leadership. Bass (1985) viewed the transformational and transactional
leadership constructs as working together in a cooperative fashion. Bass later
developed the Multifactor Leadership Questionnaire (MLQ) to assess the different
leadership styles.

Why is this page out of focus?
This is a Premium document. Become Premium to read the whole document.
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

•  –

Figure 4: Bass models of full range of transformational, transaction and laissez faire
leadership. Source: Adapted from Leadership Theory and Practice (Northhouse 1997).
2.6.3 Similarities between Bass (1985) and Buns (1978)
Bass (1985) expanded the work of Burns (1978) and House (1977). Bass9s
(1985) definition of transformational leadership has several similarities to Burns9s
(1978) in several aspects. First, both observe the transformational leaders attempt to
raise the needs of the team and promote changes in the individuals, groups, and
organisational performance. Secondly, both depend on Maslow9s (1954) Hierarchy of
Needs in their models to explain the relationship between the transformational
leadership and the follower9s motivational bases. According to Bass (1985), the task
of the leader is to motivate people in the organisation to achieve their goal, make the
extra effort, and work beyond expectation. The leaders9 intent is to transform the
Leadership Styles and Healthcare Management in Jordan and Worldwide Aladeen Alloubani R.N, Ph.D.

• 1 –

teams9 needs from a lower level to a higher order level. Burns (1978) considers
Maslow9s hierarchy of needs fundamental to the transformational process. Both
theorists consider the elevation of need level in transformational leadership as a moral
process. For example, employees would require a job description, an office space and
equipment to perform their tasks prior to being involved in career counselling or
committing to team interests or organisational performance.
2.6.4 Differences between Bass (1985) and Burns (1978)
Bass9s (1985) model differs from Burns9s (1978) model in three respects. Bass
added the expansion of the teams9 needs and wanted. He suggests that transactional
leaders attempt to satisfy the current needs of their staff through the exchange process.
For instance, leaders can bestow salary or promotion as a reward for work. Secondly,
Burns views transformational leadership as entailing a moral imperative that is
necessary to elevate what was good rather than evil for the person. Thirdly,
transactional and transformational leadership are viewed differently. Transformational
leadership is on opposite ends of a continuum model of transactional leadership. One
type excludes the other, and the person is either transformational or transactional. In
contrast Bass (1985) argues that the individuals can display both transformational and
transactional leadership qualities and that the transformational leadership is not
effective if it exists without transactional leadership (Bass, 1985).