Health Ethics 141 - Ethical Leadership

Pharmacy 1st year UP manila

Management

System focused, accepts the status quo

Leadership

People focused, challenges the status quo

Natural Leadership Styles

• Directive

• Consultative

• free-rein

Directive Leadership

Objectives and control

Consultative Leadership

People focused

Free-rein Leadership

Freedom

Founder of Lewin’s Leadership

Kurt Lewin 1939

Lewin’s leadership

• Authoritarian (autocratic)

• Participative (democratic)

• Delegative (laissez-faire)

Authoritarian (authoritarian) Leadership

Individual Control

Participative (democratic) Leadership

People focused

Delegative (laissez-faire) Leadership

Freedom

Color Leadership

• Green

• Yellow

• Red

• Blue

Green leadership

People's people

Yellow Leadership

Action, leading by example

Red Leadership

Logic based solutions

Blue Leadership

Dream and inspire towards a bigger picture

Leadership Theories

• Great Man

• Trait

• Contingency (Situational)

• Style and behavior

• Process

• Transactional

• Transformational

Great man Theory

Great leaders are born not made

Trait Theory

Born leaders have traits that distinguish them from non leaders

Emergent Traits

Hereditary traits

Effectiveness Traits

Experienced and Learned traits

Contingency (Situational) Theories

There is no one best type of leadership as it depends on the situation

Style and Behavior theory

Leadership is based on behavior and actions (autocratic, democratic, laissez-faire) rather than traits

Process Leadership Theory

Leadership is a process and act as stewards of the organization’s vision

Transactional Theories

Give-and-take relationship between leaders and followers

Transformational Theory

Strong connection between leader and followers, leading them to maximize potential

Transactional Leadership Style

Uses rewards to enhance follower’s motivation

Component Rewards of Transactional Leadership Style

• Contingent

• Management by exception (active)

• Management by exception (passive)

Contingent reward

Set goals and gives these rewards when met (material reward, reciprocity)

Active Management by exception

Monitor the team and step in when something happens, maintains status quo

Passive Management by Exception

Hands off approach, no goal setting and only step in when something happens

Four Factors of Transformational Leadership Style

• Idealized influence

• Inspirational motivation

• Intellectual stimulation

• Individualized consideration

Transformational Leadership Style

Values followers and inspires them to perform better

Sections in Healthcare Leadership Models

• First Section

• Second Section

• Third Section

• Fourth Section

First Section

Defines Stakeholders, challenges, and value

Section Section

How health providers provide leadership to attain goals

Third section

Leadership education and development

Fourth Section

Servant leadership as the best model for healthcare

Leadership Models in healthcare

Patients desire highest quality care with less cost, even with the challenge of competing interests and complexity of the system

Dimension of Challenges in Healthcare

• Increasing Value

• Ability to collaborate

• High degree of professionalism

• Enables honest communication

• Teamwork

Servant Leadership

Prioritizes the needs and goals of others, helping them succeed and grow.

NHS Healthcare Leadership Model

• Inspiring shared purpose

• Leading with care

• Evaluating information

• Connecting our service (collaboration)

• Sharing the vision

• Engaging the Team

• Holding to Account (expectations)

• Developing capability

• Influencing for Results (network of influence)

Ethical Leadership

Set high ethical standards within the team

Ethical Leadership according to Brown

“demonstration of normativeley appropriate conduct through personal actions and interpersonal relationships, and the promotion of such conduct to followers through two-way communication, reinforcement, and decision making“

Ethics Meaning

Greek ethos, code of values and principles that guide behavior with respect to right or wrong

Rationalizations for Unethical Behavior

• its standard practice everyone does it

• Its not a big deal

• Its not my responsibility

• I want to be loyal

How to confront unreported unethical behavior

• Treat confict as business matter

• Ethical dillemmas are part of the job

• Act authentically

• Challenge rationalizations

• Expose faculty thinking

• Make long term risks more specific

• Present alternative solutions to unethical actions

Traits of ethical leaders

• Honesty

• Trustworthiness

• Integrity

Values of ethical leaders

• Pride

• Patience

• Prudence

• Persistence

• Perspective

Two aspects to ethics

• Ability to discern right from wrong

• Committment to do what is right

Leaders role in fostering ethical behavior

• Leader

• Constituents

• Outcome

• Process/skills

• Situation context

• Ethics

determinants in highly ethical organizations

• Accept personal responsibility for actions of organization

• Devotion to fairness with an emphasis on other person

• Comfort in interacting with external groups

• Tying all activities with an overall purpose

Profession

Group of people that provide a specifically recognized service that cannot be provided by average layperson

Common Characteristics of Professions

• Systematic theory and body of knowledge

• Professional authority and special privilages

• Social utility and community sanction

• Ethical codes and internal control

• Professional culture and organizations

Professional Organizations

Establish group identity, ethos, and committment to common goals. Assist with licensure, CPD, togetherness, and connection to network.

Professionalism

Alllegiance to the ethos and practices that characterize the profession

Pharmacy Practice is govered by

• Ethical

  • Universal ethics

  • code of ethics

  • moral norms

  • patient rights

• Professional

  • minimum competency standards

  • practice standards

  • institutional standards, policy, guidelines

• Legal

  • constitution

  • laws

  • issuances

• Personal

  • moral values

  • religious beliefs

  • cultural norms

Tenets of professionalism

• Professionals recieve certain benefits and special autonomy

• Society demands higher degree of trust and expectations

Tenets of professionalism; Pharmacy

Must have full knowledge and skills to be a competent practicioner, and a lifelong committment to patients and society

Wheel of tenets of professionalism

• Spokes - behaviors of an individual

• Hub - core set of values

• Tire - all qualities of professionalism

Oath of a pharmacist

ACCP Tenets

• Altruism (patient as top priority)

• Honesty and integrity

• Respect for others

• Professional Presence (act in professional manner)

• Professional Stewardship (engage in profession/orgs/school)

• Dedication and commitment to excellence

Code of ethics focus areas

• Patient

• Community

• Profession

• Business

• Other health care professionals

Patient focus area

• health and wellbeing of patient must be the priority

• due respect for autonomy and rights of patient

• encourage patient to be active participants in decision making

Community focus area

• protect public trust and reputation of profession

• assume responsibility and accountability in provision of health

profession focus area

• commits to the enhancement and development of the profession

• updates relevant knowledge and skills

• agrees only to practice where professional independence and integrity is allowed

business practices focus area

• abides by laws and issuances governing business practice in the country

• upholds the welfare of patients and consumers

• safeguards practice from unethical and unprofessional influence

Other health professionals focus area

• collaboratively works with other health professionals for better health outcomes of patients and consumers

Competency Standards

• Global

  • GPP

  • Global competency framework

  • FIP professional standards

• National

• Institutional

  • Standard theraputic guidelines

  • dispensing guidelines

  • antibiotic guidelines

  • formulary system

  • management guidelines for chronic illness

PPha Core values

• Integrity

• Competence

• Professionalism

• Altruism

• Solidarity

Clinical Pharmacy

Optimizes medication therapy, promotes health, disease prevention - care for patients, and can occur in any practice setting

Standards for clinical pharmacist (ACCP - american college of clinical pharm)

• Qualifications

• Process of care

• Documentation

• Collaborative, team based practice

• professional development and maintenance of competence

• professional and ethics

• research and scholarship

• additional responsibilities

self audit or self assessment forms

• should assess the extent to which agencies have practices/policies in place to protect clients and identify ethical risks and complaints

• Awareness of ethical standards

• Adherence to relevant regulations

• strengthening of decision making process and minimize risks in operations

• support for an ethical culture in the profession or organization

• enhancement of professional accountability and development

Topic areas of self audit or self assessment forms

• Mission, strategy, evaluation (planning and strategy)

• Leadership: board, staff, volunteers (leadership and cultural competency)

• Legal compliance and ethics

• Finance and operations

• Resource development (resource plan, source of income, gifts, fundraising)

• Public awareness, engagement, advocacy

Consensus framework for ethical collaboration between patient;s organizations, healthcare professionals and the pharmaceutical industry

• general toolkit to develop policies

• Put patients first

  • optimal care for all

  • partnerships (collaboration)

• support ethical research and innovation

  • clinical research

  • objective clinical results

• ensure independence and ethical conduct

  • gifts, sponsorship, affiliation

• promote transparency and accountability

  • fees for services

  • clinical research transparency

Garcia’s article;

• climate of integrity

  • set example through strong leadership

  • set realistic goals

  • provide training

  • distinguish between compliance and ethics

• credibility, values and mission → highly ethical org

  • cred - establish honor and integrity

  • values → guide ethical behavior

  • Mission → driving purpose and committment