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  1. CHAPTER 9 Toxic Organizations and People: The Leader as Transformer The workplace can be a positive crucible, not a mind-bending and spirit-shattering one. -William Lundin and Kathleen Lundin (1993)

  2. DYSFUNCTIONAL BEHAVIORS THAT TYPICALLY IMPAIR HEALTH CARE ORGANIZATIONS INCLUDE: • Antisocial behaviors • Toxic mentoring • Neurotic and self-defeating behaviors • Organizational practices that are prone to dysfunction • Organization characteristics that reinforce dysfunction • 10 principles designed to minimize organizational toxicity

  3. HEALING IS OUR BUSINESS? INSERT Figure 9-1 Adequate Nutrients and Adequate Cleansing Results in a Balance of Health Harmony, and Energy

  4. Insert Figure 9-2 Excess Nutrients Lead to Obesity and to Stress and Dysfunction

  5. TOXIC BEHAVIORS • Vertical Authority Structure • Ten Sources of Organizational Toxicity: • Vertical authority structure • Inequitable reward and recognition practices • Abuse of power • Lack of respect for the work force • Failure to manage unmotivated employees • Tolerance of antisocial behavior • Toxic mentoring • Inconsistency and dishonesty • Imbalance between work and personal life • Advocacy gone awry

  6. TEN PRINCIPLES FOR MINIMIZING TOXIC BEHAVIOR IN ORGANIZATIONS • Principle 1: Know Thyself • Identifying your values • Your outlook on life • The importance you place on integrity • Leaders need to listen to what others have to say about them and look carefully at their style of communication and the way they treat point-of-service workers • Leaders should: • Look at themselves • Confront their emotions • Acknowledge the pain and resentment of employees

  7. Principle 2: Walk The Talk • To act in accordance with expressed values • Building trust between two individuals requires the words and actions of each to be congruent • In times of chaos, the importance of constancy of values increases • A new contract needs to be fashioned to ensure that employees are not victimized or windup working in a trustless environment

  8. Principle 3: Be Willing To Listen • Listening is an essential part of effective problem solving and decision making • Leaders must explore multiple issues and gather myriad data, both of which tasks begin with critical listening • Principle 4: Value The Truth of the Whole • Leadership team should have room for a whole constellation of personality styles to ensure the effectiveness of its decision-making practices

  9. Principle 5: Employer Employees • Leadership expertise is easily identified in action but difficult to describe in its richness • Principle 6: Build Relationships on Respect • Behave so as to preserve every person’s dignity • Encourage employees to talk with each other • Encourage self-improvement • Give employees feedback on their performance • Be open to new ideas • Encourage employees to do their best • Compensate employees fairly for the work they do

  10. Principle 7: Act as an Agent of Transformation • Quantum leaders also: • Encourage employees to voice concerns and work collaboratively to identify and address dissatisfaction • Do not threaten retaliation when employees express negative emotions or opinions • Recognize discrepancy between ideal career progression and reality • Seek to transform career pathways into a progressive career management program • Recognize that employee loyalty has advantages and disadvantages

  11. Insert Exhibit 9-7 Organizational Strategies To Minimize Career Entrenchment

  12. Principle 8: Screen Job Candidates for Dysfunction • Principle 9: Expect Accountability Insert Exhibit 9-8 Interviewing To Minimize Toxicity

  13. Principle 10: Reward Value-Adding Behaviors • In a quantum health care organization, the care providers work to ensure that the patients: • Experience an improvement in their clinical condition • Improve their ability to care for themselves • Learn more about their condition and its treatment • Are aware of the elements of a healthy lifestyle

  14. The main tasks of the leaders of a quantum health care organization include: • Hiring and developing a work force capable of achieving the patient outcomes • Retaining and continuing to develop the care providers needed to meet the organization’s future needs. • Creating a system in which providers and leaders can influence the context of care provision based on their understanding of what is needed and what they are capable of doing • Fostering therapeutic relationships between leaders, providers, and patients that focus on the values and beliefs of the patients