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• W3087207838 abstract "In the context that leadership matters and that leadership competencies differ from those needed to practice medicine or conduct research, developing leadership competencies for physicians is important. Indeed, effective leadership is needed ubiquitously in health care, both at the executive level and at the bedside (eg, leading clinical teams and problem-solving on the ward). Various leadership models have been proposed, most converging on common attributes, like envisioning a new and better future state, inspiring others around this shared vision, empowering others to effect the vision, modeling the expected behaviors, and engaging others by appealing to shared values. Attention to creating an organizational culture that is informed by the seven classic virtues (trust, compassion, courage, justice, wisdom, temperance, and hope) can also unleash discretionary effort in the organization to achieve high performance. Health care-specific leadership competencies include: technical expertise, not only in one’s clinical/scientific arena to garner colleagues’ respect but also regarding operations; strategic thinking; finance; human resources; and information technology. Also, knowledge of the regulatory and legislative environments of health care is critical, as is being a problem-solver and lifelong learner. Perhaps most important to leadership in health care, as in all sectors, is having emotional intelligence. A spectrum of leadership styles has been described, and effective leaders are facile in deploying each style in a situationally appropriate way. Overall, leadership competencies can be developed, and leadership development programs are signature features of leading health-care organizations. In the context that leadership matters and that leadership competencies differ from those needed to practice medicine or conduct research, developing leadership competencies for physicians is important. Indeed, effective leadership is needed ubiquitously in health care, both at the executive level and at the bedside (eg, leading clinical teams and problem-solving on the ward). Various leadership models have been proposed, most converging on common attributes, like envisioning a new and better future state, inspiring others around this shared vision, empowering others to effect the vision, modeling the expected behaviors, and engaging others by appealing to shared values. Attention to creating an organizational culture that is informed by the seven classic virtues (trust, compassion, courage, justice, wisdom, temperance, and hope) can also unleash discretionary effort in the organization to achieve high performance. Health care-specific leadership competencies include: technical expertise, not only in one’s clinical/scientific arena to garner colleagues’ respect but also regarding operations; strategic thinking; finance; human resources; and information technology. Also, knowledge of the regulatory and legislative environments of health care is critical, as is being a problem-solver and lifelong learner. Perhaps most important to leadership in health care, as in all sectors, is having emotional intelligence. A spectrum of leadership styles has been described, and effective leaders are facile in deploying each style in a situationally appropriate way. Overall, leadership competencies can be developed, and leadership development programs are signature features of leading health-care organizations. FOR EDITORIAL COMMENT, SEE PAGE 902Leadership matters. Consider our recent history with the coronavirus disease 2019 pandemic. In general, states whose governors acted both early with full awareness of the epidemiology and risk, and definitively (eg, by closing schools, mandating masks, advocating social distancing, implementing testing and contact tracing), experienced flattened curves while states with more laissez faire leadership bore greater disease burden and sequelae. Recognizing that leadership and followership are complementary attributes and are intertwined, and that organizational performance also reflects the strength of organizational culture, effective leadership is characterized by discrete, teachable competencies coupled with formative experience.1Cohen H.B. An inconvenient truth about leadership development.Org Dynamics. 2019; 48: 8-15Crossref Scopus (6) Google Scholar FOR EDITORIAL COMMENT, SEE PAGE 902 The current article first reviews the rationale for great leadership and then discusses a leadership paradox in medicine; that is, that the predominant leadership styles—commanding and pacesetting—that have been traditionally celebrated in health care are actually antithetical to best leadership practices. Attention then turns to a brief summary of various leadership models, emphasizing that despite using widely varying vocabularies, these models all converge on some core principles and attributes of effective leaders, including the classical virtues. Finally, leadership styles and the model of situational leadership are reviewed, emphasizing the need to pivot one’s leadership style to the context and to the characteristics of those being led. The discussion focuses on the applicability of leadership principles for the chest physician, whether practicing as a clinician leading a team of caregivers or serving in a formal, titled leadership role. This article is the first of a four-part series2Stoller JK. Leadership essentials for the chest physician: emotional intelligence [published online ahead of print September 18, 2020]. Chest. https://doi.org/10.1016/j.chest.2020.09.093.Google Scholar, 3Stoller JK. Leadership essentials for the chest physician: change [published online ahead of print September 21, 2020]. Chest. https://doi.org/10.1016/j.chest.2020.09.094.Google Scholar, 4Stoller JK. “How I do it”: building teams in healthcare [published online ahead of print September 21, 2020]. Chest. https://doi.org/10.1016/j.chest.2020.09.092.Google Scholar that discusses essential leadership competencies for the chest physician. Subsequent articles address emotional intelligence and its primacy as a leadership competency,2Stoller JK. Leadership essentials for the chest physician: emotional intelligence [published online ahead of print September 18, 2020]. Chest. https://doi.org/10.1016/j.chest.2020.09.093.Google Scholar change management,3Stoller JK. Leadership essentials for the chest physician: change [published online ahead of print September 21, 2020]. Chest. https://doi.org/10.1016/j.chest.2020.09.094.Google Scholar and teambuilding.4Stoller JK. “How I do it”: building teams in healthcare [published online ahead of print September 21, 2020]. Chest. https://doi.org/10.1016/j.chest.2020.09.092.Google Scholar Another important leadership competency (conflict and negotiation strategies) has been previously nicely discussed by Nguyen et al.5Nguyen H.B. Thomson C. Jarjour N. et al.Leading change and negotiation strategies for division leaders in clinical medicine.Chest. 2019; 156: 1246-1253Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar The need and opportunities for leadership are ubiquitous. Bohmer6Bohmer R.J. Leadership with a small “l”.BMJ. 2010; 340: c483Crossref Google Scholar has framed the concepts of “small l” and “big L” leadership to cement the idea that leadership is needed broadly throughout health care. The concept of “small l” leadership emphasizes the importance of leading in clinical “microsystems”; for example, solving a care delivery challenge on a ward with the ward team or improving reporting on “near-miss” events to enhance patient safety. “Small l” leaders can be the bedside nurse, the pulmonary consultant, the nurse clinician, or the medical student. “Small l” leaders may lack a formal leadership title but articulate a vision for providing high-quality care that goes beyond the transactional steps of writing orders and reviewing test results. They lead by “being and doing.”6Bohmer R.J. Leadership with a small “l”.BMJ. 2010; 340: c483Crossref Google Scholar Like all leaders (both “small l” and “big L” leaders [ie, those with formal leadership roles and titles]), “small l” leaders envision a better future state and create a culture; they act in ways that are consistent with their espoused values. They also manage, by establishing accountability and monitoring performance. “Small l” leadership emphasizes that leadership is not limited to “big L” leaders (eg, those with formal leadership titles such as department chair, dean, hospital president, or chief executive officer). Characterization by Bohmer6Bohmer R.J. Leadership with a small “l”.BMJ. 2010; 340: c483Crossref Google Scholar of the “small l” leader also invites considering the difference between leading and managing. Leading and managing are complementary7Kotter J. What leaders really do.Harv Bus Rev. 1990; 68: 103-111PubMed Google Scholar,8Schein E. Organizational Culture and Leadership.5th edition. John Wiley and Sons, Hoboken, NJ2017Google Scholar and share some common attributes; both encompass deciding what needs to be done, creating networks of people to accomplish the stated goals, and establishing accountability to assure that the work gets done. At the same time, leading and managing differ in that managing is about predictability and order and leadership is about envisioning a future state that disrupts the status quo. Similarly, Schein8Schein E. Organizational Culture and Leadership.5th edition. John Wiley and Sons, Hoboken, NJ2017Google Scholar has characterized the distinction between managing and leading: “If one wishes to distinguish leadership from management or administration, one can argue that leadership creates and changes cultures, while management and administration act within a culture.” Table 1 summarizes the difference between leading vs managing.7Kotter J. What leaders really do.Harv Bus Rev. 1990; 68: 103-111PubMed Google ScholarTable 1Attributes of Managing vs LeadingManagingLeadingAim is predictable, orderly resultsAim is to produce changeInvolves planning and budgetingInvolves vision and setting directionInvolves organizing and staffingInvolves aligning peopleInvolves controlling and solvingInvolves motivating and inspiringAfter Kotter.7Kotter J. What leaders really do.Harv Bus Rev. 1990; 68: 103-111PubMed Google Scholar Open table in a new tab After Kotter.7Kotter J. What leaders really do.Harv Bus Rev. 1990; 68: 103-111PubMed Google Scholar Beyond the importance of “small l” leadership in health care,6Bohmer R.J. Leadership with a small “l”.BMJ. 2010; 340: c483Crossref Google Scholar leadership by physicians also matters at higher organizational levels (eg, at the executive level). Several observational lines of evidence support this view.9Goodall A.H. Physician-leaders and hospital performance: is there an association?.Social Sci Med. 2011; 73: 535-539Crossref PubMed Scopus (225) Google Scholar, 10Stoller JK, Goodall A, Baker A. Why the best hospitals are managed by doctors. Harv Bus Rev. December 27, 2016. https://hbr.org/2016/12/why-the-best-hospitals-are-managed-by-doctors. Accessed November 10, 2020.Google Scholar, 11Tasi M.C. Keswani A. Bozic K.J. Does physician leadership affect hospital quality, operational efficiency, and financial performance?.Health Care Manage Rev. 2019; 44: 256-262Crossref PubMed Scopus (58) Google Scholar As part of her “theory of expert leadership,” Goodall9Goodall A.H. Physician-leaders and hospital performance: is there an association?.Social Sci Med. 2011; 73: 535-539Crossref PubMed Scopus (225) Google Scholar,10Stoller JK, Goodall A, Baker A. Why the best hospitals are managed by doctors. Harv Bus Rev. December 27, 2016. https://hbr.org/2016/12/why-the-best-hospitals-are-managed-by-doctors. Accessed November 10, 2020.Google Scholar has shown that top-ranking US News and World Report hospital status is significantly associated with having a physician (vs a non-physician) chief executive officer. Similarly, in an analysis of the 115 largest US hospitals in 2015, Tasi et al11Tasi M.C. Keswani A. Bozic K.J. Does physician leadership affect hospital quality, operational efficiency, and financial performance?.Health Care Manage Rev. 2019; 44: 256-262Crossref PubMed Scopus (58) Google Scholar showed that the only significant correlates of high-quality ratings and of hospital efficiency (ie, inpatient days per bed per year) ratings were having a physician chief executive officer. Although these data are correlational and therefore cannot establish causality, widely recognized benefits of hospital physician leadership regard the “street credibility” that physicians may uniquely enjoy, the enhanced followership that may result from this “street cred,” and an enhanced understanding of the clinical quality issues that are core to organizational mission and success. Further evidence supporting Goodall’s “theory of expert leadership” includes concordant observations from other sectors. For example, universities in which the president is an accomplished research scholar have higher degrees of scholarship. Formula 1 racing teams in which the principal was a driver himself or herself with at least 10 years of driving experience were 16% more likely to gain a podium position than those without a driver principal. In short, when organizational leaders have “walked the walk,” organizations tend to perform better. Health care is beset by a paradox of leadership. On the one hand, as discussed in the article in this series on teamwork,4Stoller JK. “How I do it”: building teams in healthcare [published online ahead of print September 21, 2020]. Chest. https://doi.org/10.1016/j.chest.2020.09.092.Google Scholar outstanding clinical outcomes in health care depend on the caliber of teamwork and collaboration among caregivers.12Stoller J.K. The clinician as leader: how, why, and when.Ann Am Thorac Soc. 2017; 14: 1622-1627Crossref PubMed Scopus (16) Google Scholar, 13Wheeler D. Stoller J.K. Teamwork, teambuilding and leadership in respiratory and health care.Can J Resp Ther. 2011; 47.1: 6-11Google Scholar, 14Gittell J. Fairfield K. Bierbaum B. et al.Impact of relational coordination on quality of care, postoperative pain and functioning, and length of stay: a nine hospital study of surgical patients.Medical Care. 2000; 38: 807-815Crossref PubMed Scopus (507) Google Scholar Furthermore, patients judge their care on the human (not technical) aspects of that care, especially on how well they perceive their caregivers function as a team in service of their getting better. However, hospitals are traditionally and characteristically siloed organizations. As an example, the traditional organization of hospitals by “guilds” into departments of medicine, surgery, pediatrics, and so forth, with subspecialties subsumed within the departments reflects longstanding organization around the pedigrees and traditional training trajectories. Of course, silos notwithstanding, even in the predominant traditional structure, in the ideal situation, physicians across disciplines work in a “matrixed” fashion15Epstein A.L. Bard M.A. Selecting physician leaders for clinical service lines: critical success factors.Acad Med. 2008; 83: 226-234Crossref PubMed Scopus (10) Google Scholar (eg, in service lines, in which care is directed to specific clinical needs). Alternative structures that are organized around the patient include models which couple surgeons and internal medicine specialists together in a single institute; for example, a heart and vascular institute that includes both cardiac surgeons and cardiologists (who frequently overlap in their care of patients with cardiac needs), a genitourinary/kidney institute that includes both nephrologists and urologists, or a dermatology/plastic surgical institute that couples dermatologists and plastic surgeons. Silos in hospitals of any sort (eg, department structures, separation of research from clinical care, separation of education from clinical care) can pose unintended but formidable barriers to collaboration among physicians. The final element of the aforementioned health-care leadership paradox involves the fact that traditional medical training has cultivated physicians as staunchly independent “heroic lone healers,”16Lee T.H. Turning doctors into leaders.Harv Bus Rev. 2010; 88: 50-58PubMed Google Scholar sometimes likened to gladiators or Viking warriors. However, gladiators and Viking warriors can be “collaboratively challenged”16Lee T.H. Turning doctors into leaders.Harv Bus Rev. 2010; 88: 50-58PubMed Google Scholar, 17Weisbord M. Why hasn’t organization development worked (so far) in medical centers.Health Care Manage Rev. 1976; 1: 17-28Crossref PubMed Scopus (76) Google Scholar, 18Stoller J.K. Developing physician-leaders: need and rationale.J Health Admin Ed. 2009; 25: 307-328Google Scholar or handicapped in working easily with others over perceived senses of hierarchy. Weisbord17Weisbord M. Why hasn’t organization development worked (so far) in medical centers.Health Care Manage Rev. 1976; 1: 17-28Crossref PubMed Scopus (76) Google Scholar cogently made this observation in an article entitled “Why hasn’t organizational developed (so far) in medical centers,” noting “Science-based professional work differs markedly from product-based work. Health professionals learn rigorous scientific discipline as the ‘content’ of their training. The ‘process’ inculcates a value for autonomous decision-making, personal achievement, and the importance of improving their own performance, rather than that of any institution.” The net effect of this paradox is that traditional selection and training produce physicians who may carry their “heroic lone healer”16Lee T.H. Turning doctors into leaders.Harv Bus Rev. 2010; 88: 50-58PubMed Google Scholar phenotype to their leadership roles, whether “small l” or “big L,” thereby potentially undermining their leadership performance. Simply put, the paradox is that although teamwork is crucial to produce the best health-care outcomes,4Stoller JK. “How I do it”: building teams in healthcare [published online ahead of print September 21, 2020]. Chest. https://doi.org/10.1016/j.chest.2020.09.092.Google Scholar,14Gittell J. Fairfield K. Bierbaum B. et al.Impact of relational coordination on quality of care, postoperative pain and functioning, and length of stay: a nine hospital study of surgical patients.Medical Care. 2000; 38: 807-815Crossref PubMed Scopus (507) Google Scholar physicians have not been traditionally selected nor trained to be team players. Clearly, change is required here3Stoller JK. Leadership essentials for the chest physician: change [published online ahead of print September 21, 2020]. Chest. https://doi.org/10.1016/j.chest.2020.09.094.Google Scholar and thankfully change is occurring, both in undergraduate and graduate medical curricula, which increasingly recognize how important collaboration is for clinical success. Furthermore, physicians who aspire to leadership are increasingly seeking and receiving formal leadership training, whether within their organizations, from professional societies, or from business schools.12Stoller J.K. The clinician as leader: how, why, and when.Ann Am Thorac Soc. 2017; 14: 1622-1627Crossref PubMed Scopus (16) Google Scholar Many different leadership models have been described, each model offering a distinctive lens and vocabulary. As a tiny sample of the myriad models and their vocabularies or leadership taxonomies, there is “servant leadership” proposed by Greenleaf,19Greenleaf R.K. Servant Leadership: A Journey into the Nature of Legitimate Power and Greatness. Paulist Press, Mahwah, NJ1977Google Scholar “technical” vs “adaptive” leadership proposed by Heifitz and Linsky,20Heifitz R. Linsky M. Leadership on the Line: Staying Alive Through the Dangers of Leading. Harvard Business School Press, Boston, MA2002Google Scholar the five levels of leadership proposed by Maxwell,21Maxwell J.C. The 5 Levels of Leadership: Proven Steps to Maximize Your Potential. Center Street, New York; Boston; Nashville2011Google Scholar and “level 5” leadership proposed by Collins.22Collins J. Level 5 leadership: the triumph of humility and fierce resolve. Harv Bus Rev. July/August 2005.Google Scholar Although each of these models and the many others unnamed here highlight distinctive attributes of effective leaders, this author’s “lumping” tendency suggests that all these models converge on several core features of effective leaders. These core features have been succinctly captured in five leadership commitments reported by Kouzes and Posner in their seminal work The Leadership Challenge23Kouzes J. Posner B. The Leadership Challenge.5th ed. Wiley, San Francisco, CA2012Google Scholar and in the seven classical virtues24Rea P. Stoller J. Kolp A. Exception to the Rule: The Surprising Science of Character-Based Culture, Engagement, and Performance. McGraw-Hill Education, New York, NY2018Google Scholar: trust, compassion, courage, justice, wisdom, temperance, and hope. The classical virtues provide a time-honored common vocabulary that undergirds strong character, great leadership, and the strong organizational culture that invites engagement and discretionary effort. Simply put, who wouldn’t want to be led by or live in a culture in which trust and compassion, wisdom, justice, and hope were the prevailing values? Consider the alternatives. Without trust, all human relationships deteriorate. We spend more time defending ourselves than flourishing. Without compassion, we are all alienated from one another. Our goals and our lives are empty and incomplete. Without courage, we wilt in the face of challenge. We choose the “easy wrong” rather than the “hard right,” and we live in a Machiavellian world in which the ends justify the means. Without justice, our relationships suffer and commitments decline because people feel they are treated unfairly. Consider what happened to everyone’s life when a Minneapolis policeman killed George Floyd by leaning on his neck. Without wisdom, we make flawed decisions. Apathy goes up and so does risk. Without wisdom, our life is devoid of meaning and purpose. Without temperance, we rush to judge, and we take unnecessary risks. We abandon our convictions, and we lose credibility. Finally, without hope, despair, cynicism, and fragility define who we become. How can we be effective as doctors without conferring hope? We recall the famous quote from the late 19th century TB physician, Edward Livingston Trudeau, “To cure sometimes, to relieve often, to comfort always.”25To comfort always.https://medicine.yale.edu/news-article/17719/#:∼:text=%E2%80%9CTo%20cure%20sometimes%2C%20to%20relieve,Lake%20in%20New%20York's%20AdirondacksDate accessed: July 10, 2020Google Scholar Hope provides comfort. Consider some examples of practicing the classical virtues in Pulmonary/Critical Care. Courage, trust, and its corollary psychological safety allow the first-year Pulmonary/Critical Care fellow to interrupt the attending’s participating in a central line placement when she observed that the attending’s gloves were inadvertently soiled. Psychologic safety, as discussed by Edmondson in the book The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth,26Edmondson A.C. The Fearless Organization: Creating Psychologic Safety in the Workplace for Learning, Innovation, and Growth. John C. Wiley, Hoboken, NJ2019Google Scholar is the ability to speak up without fear of retribution or humiliation. Every health-care organization seeks psychologic safety in pursuit of the highest possible quality and patient safety. Without it, no one calls near-misses, we lack a just culture, and we do not get better. Another virtue, compassion, hopefully underlies everything we do in Pulmonary/Critical Care practice and is surely in evidence when an intensivist engages in a thoughtful and caring discussion with a nonagenarian about end-of-life choices. Similarly, both justice and wisdom underlie how we optimally and holistically select incoming Pulmonary/Critical Care fellows for our programs. These virtues are leadership competencies that create character; when we are good at who we are (ie, our actions and informed by and abide by the virtues), we become better at what we do. Furthermore, when organizational culture is crafted around the virtues, engagement and discretionary effort blossom and high performance follows, including in health care.24Rea P. Stoller J. Kolp A. Exception to the Rule: The Surprising Science of Character-Based Culture, Engagement, and Performance. McGraw-Hill Education, New York, NY2018Google Scholar The robustness of the concept that the seven classical virtues24Rea P. Stoller J. Kolp A. Exception to the Rule: The Surprising Science of Character-Based Culture, Engagement, and Performance. McGraw-Hill Education, New York, NY2018Google Scholar and the five leadership commitments of Kouzes and Posner23Kouzes J. Posner B. The Leadership Challenge.5th ed. Wiley, San Francisco, CA2012Google Scholar are core to leadership lies in their being independently validated by great thinkers and great leaders over time.27Phillips D.T. Lincoln on Leadership: Executive Strategies for Tough Times. DTP/Companion Books, IL2009Google Scholar,28Stoller JK, Rea P, Kolp A. Being our best selves: hidden in full view. Hektoen Int J. https://hekint.org/2020/06/24/being-our-best-selves-hidden-in-full-view/. Accessed November 10, 2020.Google Scholar For example, the five leadership commitments that Kouzes and Posner23Kouzes J. Posner B. The Leadership Challenge.5th ed. Wiley, San Francisco, CA2012Google Scholar derived in their grounded theory research—challenge the process, inspire a shared vision, enable others to act, model the way, and encourage the heart (Table 2)—are uncannily similar to observations made a century earlier by one of America’s great leaders, President Abraham Lincoln.27Phillips D.T. Lincoln on Leadership: Executive Strategies for Tough Times. DTP/Companion Books, IL2009Google Scholar Similarly, Aristotle and philosopher Will Durant’s comments about the virtues (“We are what we repeatedly do. Excellence then is not an act but a habit” and “moral excellence is the result of habit or custom”29Fact check: did Aristotle say: “We are what we repeatedly do?”.https://checkyourfact.com/2019/06/26/fact-check-aristotle-excellence-habit-repeatedly-do/#:∼:text=Story%20of%20Philosophy.%E2%80%9D-,Fact%20Check%3A,philosophers%20to%20have%20ever%20lived.&text=There%20is%20no%20reason%20to,is%20a%20well%2Dknown%20misattributionDate accessed: July 9, 2020Google Scholar) replicates Heraclitus’ observation that “Character is destiny,”30Which Greek philosopher said: “Character is destiny”?.https://education.seattlepi.com/greek-philosopher-said-character-destiny-6827.html#:∼:text=%E2%80%9CCharacter%20is%20destiny%2C%E2%80%9D%20is,by%20his%20own%20inner%20characterDate accessed: July 8, 2020Google Scholar Plutarch’s comment that “What we achieve inwardly will change outer reality,”31What we achieve inwardly will change outward reality.https://www.brainyquote.com/quotes/plutarch_120365Date accessed: July 10, 2020Google Scholar and Confucius’ statement that “All people are the same: only their habits differ.”32Confucius’ quotes.https://www.goodreads.com/quotes/808879-all-people-are-the-same-only-their-habits-differDate accessed: July 10, 2020Google Scholar None knew one another but all converged on common truths about excellence and about what makes great leaders.Table 2Replication of the Five Leadership Commitments of Kouzes and Posner by President Abraham LincolnLeadership Commitment (From Kouzes and Posner23Kouzes J. Posner B. The Leadership Challenge.5th ed. Wiley, San Francisco, CA2012Google Scholar)Lincoln on Leadership (From Phillips27Phillips D.T. Lincoln on Leadership: Executive Strategies for Tough Times. DTP/Companion Books, IL2009Google Scholar)Challenge the processSearch out challenging opportunities to change, grow, innovate, and improveExperiment, take risks, and learn from the accompanying mistakes“Choose as your chief subordinates those people who crave responsibility and take risks”“If you never try, you’ll never succeed”Inspire a shared visionEnvision an uplifting and ennobling futureEnlist others in a common vision by appealing to their values, interests, hopes, and dreams“You must set…fundamental goals and values that move your followers.”“When you extinguish hope, you create desperation”Enable others to actFoster collaboration by promoting cooperative goals and building trustStrengthen people by giving power away, providing choice, developing competence, assigning critical tasks, and offering visible support“Delegate responsibility and authority by empowering people to act on their own”Model the waySet the example by behaving in ways that are consistent with shared valuesAchieve small wins that promote consistent progress and build commitment“One of the most effective ways to gain acceptance of a philosophy is to show it in your daily actions”Encourage the heartRecognize individual contributions to the success of every projectCelebrate team accomplishments regularly“Remember, everyone likes a compliment” Open table in a new tab Just as there are multiple models of generic leadership competencies, so too are there many constructs for specific leadership competencies in health care. For example, the National Center for Healthcare Leadership model33National Center for Healthcare Leadership.http://www.nchl.org/static.asp?path=2852,3238Date accessed: July 6, 2020Google Scholar bundles 26 individual competencies into three doma" @default.
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