Looking to the future

Which approach to practice management is best? 

MOST people will readily agree that organisations benefit from strong leadership. But when it comes to deciding which leadership approach is the most effective, opinions tend to vary. Much of the theory revolves around two conflicting models.

The much-praised ‘transformational’ model focuses on being visionary, charismatic and influential, while the much-maligned ‘transactional’ approach is defined as procedural, mechanistic and process-focused. So when it comes to practice management, which one is best?

The answer is that practice managers need to incorporate elements of both models in order to be truly effective within their roles. In a smaller organisation such as a general practice, the most effective managers are those who can be both a strong leader and a good planner/organiser.

One of the most important elements linked to strong, effective leadership is the presence of a clearly defined vision of where the practice is going. This ‘visionary’ side of leadership can be a uniting and guiding force and is a true combination of both leadership models. While visualising the future falls under the ‘transformational’ approach, a failure to map the practical steps to get there (the transactional side) can leave great purpose and vision without any substance or direction.

So how exactly do you go about visualising the practice’s future? The first practical step is to recognise where the practice is now, and the people best placed to consider this are those who work in it every day. A useful activity that will help form a holistic picture – and give people the opportunity to simply get together – is to protect some time and undertake a SWOT analysis. This process will look at the strengths, weaknesses, opportunities and threats that might impact on your practice.

It’s important to involve as many staff members as you can and then split your team into multi-disciplinary groups. Ask each group to consider what might impact upon the practice – the people, processes, facilities, patient group and overall healthcare environment. Thinking around this, identify any strengths that the practice can build upon and any weaknesses that you may need to address (often the internal aspects of the practice). Consider external aspects of the organisation (are there opportunities that you can take advantage of) and think about any threats that you might need to be aware of or mitigate.

Next, pick out the elements of the analysis that you will need to prioritise and focus on. Which opportunities are a good fit to the practice’s strengths? It might be that the skill set within your team provides an opportunity to introduce a new service. Which threats or weaknesses need addressed within the planning timeframe to allow the practice to continue to operate effectively and safely? With finite resources available, effective prioritising is essential.

When priorities are identified, allocation of tasks and responsibilities to achieve these is the natural next step. Being the practice manager does not mean that you are responsible for everything – no matter how much others may think this is the case!

Effective delegation and recognition of how tasks should be allocated is the aim here and understanding your team and their skills, knowledge and preferences is key. This can allow you to identify any gaps within your team and any skills or tendencies that people may have that you are not utilising – all of this should have formed part of the practice analysis. Ensuring that tasks are assigned to the correct team members will help achieve the vision. For example, a staff member who thrives on dealing with people is probably not the best person to allocate a back office, number-crunching project. You are aiming for a good match in relation to tasks and skills and this involves ‘knowing’ your team. Ask yourself:

• Do you understand their capabilities, individually and as a whole?

• Do you understand team members’ preferences (and your own) with regard to communication and learning styles?

• Do you understand what motivates them?

• Are you aware of your team’s strengths and weaknesses (and yours)?

This understanding can let you tap into the informal leaders within your organisation who can be hugely beneficial to you as practice manager. These are the go-to people – the receptionists who have influence, the nurses who can relate and relay well. Identifying these people, matching the skills and tasks then actively involving them in projects that require leadership from within can strengthen any efforts on your part.

A practice analysis provides an overall picture of the practice – a situational analysis of where you are now and where you should be focusing your efforts – that is followed by the development planning to determine how you might get there. Bringing everyone together to understand the practice and the direction it will be taking is a transformational approach – forming the vision. The practical progression from that stage to then prioritising and mapping out the actual steps involved uses the transactional elements. It is an effective combination of both approaches, or a leader-manager approach if you will.

Cherryl Adams is a trainer and risk facilitator with MDDUS Training and Consultancy