what is a leader? “leadership is not about personality; it’s about behavior – an observable...
TRANSCRIPT
What is a Leader?“Leadership is not about personality; it’s about behavior – an observable set of skills and abilities.”
Model the Way
Inspire a Shared Vision
Challenge the Process
Enable Others to Act
Encourage the Heart
The Leadership Challenge: Kouzes and Posner
Are Managers Leaders?
A manager is someone who:
• Plans and budgets• Organizes and allocates
resources• Controls and solves
problems
A leader is someone who:
• Shows a direction• Aligns and influences• Motivates and inspires!
Designated Leaders
Managers first
Assigned role and accountabilities
Manage resources
Establish clear goals (shared vision)
Facilitate open communication
Anticipate and solve problems
Conflict resolution!!
Situational LeadersAny team member who has the skills to manage the situation
“The principle role of a situational leader is to mobilizeand support the Situational Awareness of the team.”
Tools for Situational LeadersBriefing:Who is on the team?Goals? Roles and Responsibilities?Plan of care? Staff? Resources?
Huddle:“touch-base”; Emerging events. Concerns!Outcomes/Contingencies? Resources?
Debrief: Process Improvement; Informal after event;Improve teamwork, improve outcomes“What should we do differently next time?”
The team:
Ben, ENT surgeon
Ron, Anesthesiologist
Mary, OR RN, ENT lead
Abby, OR RN, orienting
Naomi, OR LPN
The list:
BMT, 2 ½ years
Tonsillectomy X 2, 4 years, 6 years
Partial Glossectomy (R), 54 years
Tonsillectomy X 2, 16 years, 21 years
NSR, 46 years
Partial Glossectomy (R)
Male, 54 years old
Heavy smoker, heavy drinker
Squamous cell cancer larynx (extensive)
Cancer base of tongue (for excision)
Heavy beard
Very poor dentition
Concerns…
Equipment issues
‘Uncommon’ intra-oral surgery
Risk of damage to teeth
Feasibility of endotracheal tube placement
How to secure the endotracheal tube
Pathology
The Briefing
Mary:
Assembled the team
Discussed equipment (airway, surgical, pathology)
We visualized the laryngeal mass
Discussed airway management plan(s)
Partial Glossectomy (R)
Very careful examination of teeth prior to induction
Small endotracheal tube, tied not taped
No throat pack
Surgeon placed Bite Block
Uneventful dissection/closure
Extubated awake in the OR
To PAR with O2 by facemask 6LPM
Adverse Event: the Huddle5 minutes after arriving in PAR, the patient removed the Bite Block
Mary:
Assembled the team in the OR, immediately
We discussed the incident and factors contributing
We discussed how to prevent recurrence
She wrote up a PSLS
Process Improvement: the Debrief
Mary:
Assembled the team
Discussed feasibility of process improvement ideas
Wrote up recommended changes to ‘the count’
Captured other ideas as suggestions
Leadership is about….
Having a vision of what is possible…
Maintaining ‘situational awareness’
“Stepping up” to support situational awareness
Maintaining communication and team processes
Innovation
Breaking down the barriers!