Batalden Paul B, Nelson Eugene C, Mohr Julie J, Godfrey Marjorie M, Huber Thomas P, Kosnik Linda, Ashling Kerri
Dartmouth Medical School, Hanover, New Hampshire, USA.
Jt Comm J Qual Saf. 2003 Jun;29(6):297-308. doi: 10.1016/s1549-3741(03)29034-1.
Leading and leadership by formal and informal leaders goes on at all levels of microsystems--the essential building blocks of all health systems--and between them. It goes on between microsystems and other levels of the systems in health care. This series on high-performing clinical microsystems is based on interviews and site visits to 20 clinical microsystems in the United States. This fifth article in the series describes how leaders contribute to the performance of those microsystems.
Interviews of leaders and staff members offer a rich understanding of the three core processes of leading. Building knowledge requires many behaviors of leaders and has many manifestations as leaders seek to build knowledge about the structure, processes, and patterns of work in their clinical microsystems. Taking action covers many different behaviors--making things happen, executing plans, making good on intentions. It focuses action on the way people are hired and developed and involves the way the work gets done. Reviewing and reflecting provides insight as to how the microsystem's patterns, processes, and structure enable the desired work to get done; what success looks like; and what will be next after that "success" is created.
The focus on the processes of leading is intended to enable more people to develop into leaders and more people to share the roles of leading.
正式和非正式领导者的引领及领导作用在微观系统的各个层面——所有卫生系统的基本组成部分——以及它们之间持续发挥。这种作用在微观系统与医疗保健系统的其他层面之间也持续存在。本系列关于高效临床微观系统的文章基于对美国20个临床微观系统的访谈和实地考察。本系列的第五篇文章描述了领导者如何促进这些微观系统的绩效。
对领导者和工作人员的访谈有助于深入理解领导的三个核心过程。积累知识需要领导者具备多种行为，并且在领导者寻求积累有关其临床微观系统中工作的结构、流程和模式的知识时会有多种表现形式。采取行动涵盖许多不同的行为——促成事情发生、执行计划、兑现意图。它将行动重点放在人员的招聘和培养方式上，并涉及工作的完成方式。回顾与反思能洞察微观系统的模式、流程和结构如何使期望的工作得以完成；成功是什么样子；以及在创造出那种“成功”之后接下来会怎样。
关注领导过程旨在使更多人成长为领导者，并使更多人分担领导角色。
