1. Perkins, Kimberly M. MEd, NHA, ACHCA, HFMA

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Leadership is always a hotly debated topic. Countless discussions and endless research produce numerous traditional and contemporary models. Effective in not-for-profit healthcare organizations, leadership theories strengthen the mission of the organization.1 But recent findings reveal a lack of relationship between leader and follower.2 Existing leadership theories don't consider the process of personal investment. This article presents investation as an original concept of contemporary leadership. It's been used specifically in not-for-profit healthcare organizations, but it's applicable to most healthcare systems.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Investation implies that existing leaders who sense potential in another individual will invest their time, knowledge, and resources to develop the member's leadership skills. All three components contribute to the investee's success as a future leader.


A brief history of leadership

Roughly 130 definitions of leadership exist and they all blur together.3,4 A common theme among these definitions is that leadership is a process of motivating others to "guide, structure, and facilitate activities and relationships in a group or organization."5 The creation of leadership models has helped demystify what makes a successful leader. Leadership models exist to identify methods of accomplishing organizational goals through various techniques utilized by healthcare leaders.6


Leadership was once thought to be an inherited trait, but contemporary theorists assert that leadership is a learned skill.7,8 Traits alone don't define leadership, rather, leadership is based on individual characteristics, approaches to situations, and the ability to handle change.9 Leadership conceptualizes a relationship between a leader and a follower-leaders can't exist without followers and vice versa.10


Leaders set the overall direction for an organization and motivate others to promote change. This is quite different from the traditional definition of management that emphasizes a leader's need to control others to accomplish goals. The general function of a leader is to produce results and motivate followers to achieve said results.11 The problem is that existing leadership theories don't take into consideration the process of finding leadership abilities in other people. The identification of leadership abilities encourages succession planning, thereby promoting organizational longevity.


Different leadership models

The conceptual framework of investation derives from a lack of personal investment not present in other leadership models. The following is a brief overview of contemporary leadership models and their attributes:


* Aversive leaders use coerciveness, intimidation, punishment, and reprimanding behaviors to obtain results. Research reveals that aversive leadership yields negative performance and negative impact on change management teams.12,13


* Authentic leaders have a genuine passion to help others through their service and dedication and are perceived as sincere individuals who gain respect through their credibility and trustworthiness.11,14


* Change-oriented leaders are highly effective only during times of change.15


* Charismatic leaders influence followers through their own personal attributes.16


* Directive leaders (commonly termed legitimate power leaders) use their position and power as a method to merely obtain results.12,17


* Distributive leaders are interdependent among other leaders and desire contribution from others. Distributive leaders are only effective in team settings that desire input rather than position.18,19


* Educational leaders focus on educational practices and structural design to intellectually help the development of others.20


* Ethical leaders are concerned with followers' moral potential and display sincere concern for others, an open commitment to ethical standards, and the desire to become a role model to others.21-24


* Empowering leaders have a desire to lead others in hopes that the members of the group will desire to lead themselves, resulting in heightened self-sufficiency.12,25


* Participative leaders encourage interaction from followers when making decisions. As one of the most interactive leadership styles, participative leaders encourage followers to develop their teamwork skills.15,26,27


* Relational leaders focus on the continual engagement of their followers and surroundings to promote accountability and dialogue.28


* Servant leaders place followers' interests before their own.29 They possess inherent levels of motivation combined with the desire to instruct and coach their followers.30,31 Revered as the leadership style that focuses on serving others, servant leadership is growing in popularity among organizations.32


* Shared leaders focus on the equal value of contributions among group members rather than on one leader.12 The transition from an individualistic into a more holistic approach of leadership fosters team work.33 Additional research has emphasized the positive impact that shared leadership has on project management and the completion of dynamic shared projects.34


* Situational leaders recognize that internal and external factors constantly change the level of interaction and involvement that a leader must display with followers.35 Further research acknowledges that situational leadership is a subpart of transformational leadership, which recognizes that leadership is subjective and no one leadership style is effective in every situation.36


* Spiritual leaders integrate their personal beliefs and core values into their followers' self-identities and development.37


* Strategic leaders focus on the long-term development and growth of an organization and often refer to the daily operational constructs of the business.38


* Transactional leaders focus on the motivating effort of completing tasks: positive completion results in reward, negative completion results in discipline.12 Transactional leaders use contingent rewards and management by exception, an active role of correction, to motivate followers.39


* Transformational leaders interact with followers and provide guidance and support to their followers to accomplish tasks and desire valuable change among their followers to promote continued leadership.40,41 Research in the field of nursing reveals that transformational leaders influence their followers by supporting higher levels of values and standards.42


* Vertical leaders focus on one elected leader within a group.12,43 Although more contemporary theorists assert the effectiveness of sharing leadership responsibilities, research also suggests that vertical leadership is highly effective among preformation phases of development.34,44


* Visionary leaders visibly transform and change their organizations, usually during times of emergency and crises because transformation isn't always necessary during stagnant times.15 A leader's vision is typically used to promote a desirable outcome or to prevent an undesirable one.45



All aforementioned leadership models fail to recognize or establish the importance of a leader identifying leadership potential in another person and dedicating time, knowledge, and resources toward developing leadership skills. According to research conducted by the original theorist of appreciative inquiry, organizational development is merely a philosophy that focuses on the reshaping and restructuring of an individual or an organization.46-48


Appreciative inquiry isn't a leadership model, but it contributes to the conceptual framework of investation whereby leaders should focus on an individual's positive attributes and potential and then act on them through personal investment. Such personalized investment may contribute to the leadership development of an individual, reshape the structure of an organization, and instill dedication from the investee. The original concept of the investation model of leadership focuses on the investment relationship among three components: time, knowledge, and resources. (See Figure 1.)

Figure 1:. The inves... - Click to enlarge in new windowFigure 1:. The investation model of leadership

The three tiers

Good leaders slow down, listen, and spend time with their investees. Research reveals a positive relationship between individual role identification and the amount of time invested in the respective role.49 Good leaders show up, share stories, and spend their social capital on others.50 In short, good leaders invest their time in others.


Knowledge is the second component in the investation model of leadership. More than mere intellect, knowledge includes the depth and breadth of a subject matter and the wisdom gained from experience. Knowledge is an infinite construct of leadership whereby spillovers, or a large exchange of ideas, encourage innovation and growth.51 These spillovers can be manipulated into a strategic development plan for investees or to gain an advantage over competition. Knowledge is a necessary resource when increasing development opportunities.52


Resources are the third component in the investation model of leadership. Resources include a variety of personalized physical assets used toward the development of an investee. Germinal work from one group of researchers explored the concept of leader-member exchange (LMX) theory, which focuses on the relationship between leader and member through various exchanges.53 The LMX theory measures member outcomes such as satisfaction, performance, and dedication. Satisfaction is measured by the overall organizational success evident by the creation of positive relationships between leader and subordinate. The LMX theory doesn't focus on the completion of tasks, rather the process of relationship-building. The investation model of leadership builds upon both the LMX theory and contemporary theories; exchanged resources influence both the leader and the investee.


Ethical assessment

Ethical considerations exist in healthcare organizations because they strive to put the needs of others first. Leadership, regardless of industry, requires the evaluation of three ethical factors:


* The level of the leader's individual morality.


* The level of the leader's means to adopt his or her own leadership style.


* The level of the leader's individual mission.54



These factors are important for leaders who desire organizational success; failure to assess for these three factors can increase the percentage of organizational and individual failure.54 The investation model requires highly ethical leaders. The conceptual framework of the investation model requires the personal investment from a leader. Unethical attributes displayed by a leader may jeopardize the successful development of the follower. Highly ethical characteristics of a leader are conveyed to the follower's attributes, thereby instilling continuous ethical behavior. These leaders must be able to adopt an individual mission for each person they elect to invest in.


Consideration for nonprofits

The review of various models of leadership uncovered a lack of identifying leadership potential in other people and dedicating time, knowledge, and resources toward such development. In the not-for-profit sector, which relies on sustainability by serving others, an opportunity to invest in future leaders may improve the likelihood of organizational success.55 The investation model of leadership is an original leadership concept aimed at filling the gap where personal investment isn't present in existing models of leadership. Not-for-profit organizations who desire to continue their mission-driven legacy may benefit from the investation model of leadership as a method of molding and personalizing future leaders.




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