Labor Issues a Hot Topic at ASHHRA Conference
ASHHRA offers a selection of
learning sessions on labor and legislative issues, including an expert
panel on labor law. Here's a sampling of what you will see at the ASHHRA 44th Annual Conference and Exposition:
Thriving (Not Just Surviving) in the Face of Big
Labor’s Assault on Health Care
Becky Brown, J.D., SPHR, Supervising VP, MSA HR Capital, Integrated
Healthcare Strategies
Kevin Haeberle, J.D., Executive VP, Practice Leader MSA HR Capital,
Integrated Healthcare Strategies
Brown and Haeberle will broaden your understanding of the current labor
movement in health care, pushing you to act proactively by creating a
comprehensive labor strategy aimed at organizational excellence.
Learning Objectives
• Assess your hospital’s current labor strategy
• Determine steps to reduce vulnerability
What’s New in the Legislative & Labor
Arena?
Les Abercrombie, SPHR, System Dir., Labor Relations, Providence Health & Services
James Trivisonno, President, IRI Consultants, Inc.
HR professionals are challenged to keep current with legislative and labor
decisions affecting organizations. Join Abercrombie, chair of the ASHHRA Advocacy Committee, and Trivisonno, as
they outline legislative and labor trends affecting health care and discuss
external and internal responses to these trends. Abercrombie will address
the legislative environment while Trivisonno will highlight successful
health care organizations.
Learning Objectives
• Discuss current legislative issues on both the state and national
levels
• Learn how the ASHHRA
Advocacy Committee and others in the field address these legislative issues
Labor / Legal Panel: HR and the Law
A panel of labor relations professionals will discuss implications of
current legislative and state legal updates, as well as their impact on
both health care and HR nationally.
Moderator
Mindy Hatton, Senior Vice President and General Counsel, Federal Relations,
American Hospital Association
Panelists
•Dr. Keith Ghezzi, Principal, Ghezzi and Associates LLC
•Ms. Carol Aaron, Vice President, Labor and Employee Relations, St. Joseph Health
Systems
•Ms. Irma Pye, Senior Vice President and Chief HR Officer, Valley
Baptist Health System
•Mr. G. Roger King, Esq., Partner, Jones Day
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Two Learning Sessions Added to Conference Program
ASHHRA added two learning sessions
to the 44th Annual Conference and Exposition program after the brochure was
published this past spring. Take a look:
Sunday, Oct. 12, 1:30 p.m. (S11A) Leader Institute Track
Making Customers Count: Emory Healthcare’s
Approach to Improving Quality of Care
Adair D. Maller, SPHR, Director of Recruitment and Retention, Emory
Healthcare
Mike Kempa, Senior Consultant, Development Dimensions International (DDI)
Emory Healthcare wanted new hires to fit into its service-driven culture to
improve patient satisfaction and employee engagement. Learn how Emory in
conjunction with DDI implemented an employee selection process and
integrated an HR system to create a more patient-friendly culture.
Learning Objectives
• Reduce turnover by hiring and managing employees who fit
• Improve clinical outcomes and patient safety with a customer
service approach
• Leverage best practices to hire employees dedicated to your
organization’s goals
Tuesday, Oct. 14, 8:15 (T7)
Passion, Purpose and Personal Accountability:
8 Simple Questions That Can Transform Your Organization Into a More
Accountable One!
Mark Sasscer, Founder & CEO, LeadQuest Consulting, Inc.
In this highly-interactive and thought-provoking session, you will be
challenged to “look in the mirror” to learn what more you can
do to improve personal and organizational accountability. This is a
“must-attend” session if you desire to raise the bar and become
even more effective as an HR Leader!
Learning Objectives
• Differentiate between personal responsibility and accountability
• Employ an 8-question model to improve their personal
accountability
• Describe how to build a more accountable organizational culture
using an evidence-based approach to change
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"Mediation Program Heads Off Litigation by
Keeping Communication Open"
Nurse.com (06/30/08) Ringler, Robyn
Pennsylvania's Abington Memorial Hospital recently launched a mediation
pilot program to avoid litigation brought by a patient or family member.
Nurses, doctors, and lawyers trained in conflict resolution openly
communicate with the patient to resolve any disputes. "In a civil
trial, once a suit is filed, the parties can't talk to each other.
Mediation brings both parties together, and that is profound," said
semi-retired RN Sheila Stieritz. The mediator stays neutral during the
process to help both sides resolve the issue. Tier one of the pilot program
involves an initial meeting between the medical professional who is the
subject of the complaint, and coaches offer the medical professional
support. Also during this phase, questions from the patient or patient's
family are answered, mistakes are identified, and responsibility is take or
apologies are offered. The second tier of the process is considered formal
mediation, in which patients choose a mediator from a panel of 30 trained
mediators--15 attorneys and 15 physicians. While no cases have gone through
both phases of the program, Abington staff indicate it helps teach
physicians conflict resolution skills and reduces the tension between
patients and their families and treating medical staff. Many staff members
role-played a variety of scenarios, including those involving medication
errors, to demonstrate how conflict resolution and mediation can prevent
litigation.
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"Paid Family and Sick Leave Campaigns Growing at
the Federal, State Level"
CCH (07/22/08)
The U.S. Department of Labor's Bureau of Labor Statistics estimates that up
to 43 percent of private industry workers are not eligible for paid sick
leave. Legislators at the federal and state level are working to require
employers to offer leave. U.S. Sen. Edward Kennedy (D-Mass.) and U.S.
Representative Rosa DeLauro (D-Conn.) introduced the Healthy Families Act
in 2007, a bill that would require private and public employers with a
workforce of 15 or more to provide at least seven paid sick days a year to
full-time workers. Part-time employees would be eligible for a pro-rated
amount of leave based upon the number of hours they work per week. The
proposed bill would require employers to give employees notice on the
availability of paid leave, keep records on compliance, and not deny an
employee's right to paid leave. The U.S. House also recently passed the
Federal Employees Paid Parental Leave Act, which provides four weeks of
paid parental leave for all federal government employees eligible for leave
under the FMLA. The bill also would enable employees to use any accumulated
sick leave to offset the 12 weeks of unpaid leave provided by the FMLA.
Several state legislatures, including California,
Connecticut, and New Jersey, have either already passed
paid leave laws or are considering similar proposals.
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"Spying Employers Raise Legal Hackles"
National Law Journal (08/18/08) Baldas, Tresa
U.S. Circuit Courts rule on both sides when it comes to employers who spy
on employees using the Family Medical Leave Act (FMLA). Some employers are
concerned that workers may be taking advantage of the FMLA by vacationing
and working second jobs when they are supposed to be home recuperating. In
a majority of cases, the courts side with the employer. In the case of Vail
v. Raybestos, the Seventh U.S. Circuit Court of Appeals approved the
employer's surveillance of a sick worker suspected of mowing lawns for
extra money while using FMLA. An attorney representing the employer in the
case claimed surveillance was used only to confirm valid suspicions.
Surveillance does uncover some abuses, but critics argue that an employer
should not second-guess a worker if they provide the proper paperwork to
support their absence. A current case pending in Ohio involves an employee who was spied
upon by his employer, Honda Motor Co., and fired for building a porch while
on leave for a concussion. The plaintiff claimed he was fired unjustly
because he was waiting for physicians from Honda to clear his return back
to work. Employers may not have all the facts when they see
"sick" employees engaging in certain behaviors, says Mark Toth,
head of the legal department for Manpower North America.
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"Older and Wiser"
Human Resource Executive (08/08) Vol. 22, No. 11, P. 35; Rowh, Mark
With older workers expected to account for over one-fifth of the American
workforce by 2016, many experts are calling upon employers to tap that
resource for their workforce needs. However, a Manpower Inc. survey reveals
that less than 20 percent of employers have recruitment programs in place
that cater to workers age 55 and over. At The Aerospace Corp., retirees can
opt for the "retire casual" program, which places workers into a
pool and assigns them to vacant positions as needed, usually within their
previous field of expertise to ensure knowledge transfer. The company
estimates the number of participants at 500 retirees, with approximately
300 working at any given time. Some older workers are reluctant to retire
because they like to work, but they would appreciate a position that has a
slower pace. HR professionals and employers must design programs that
attract these talented and knowledgeable workers, but also meet their needs
for flexibility and a slower pace while fulfilling an organizational gap.
Employers note that having multiple generations in one workforce can be
challenging, but training workers in new communication and management tools
can reduce friction and generate camaraderie. Aflac is just one company
that offers a comprehensive multigenerational training program that
highlights the major political and world events shaping each generation and
its approach to work, among other elements. HR staff must conduct employee
surveys to gauge what they want most from retirement and a prolonged work
life. Additionally, mature workers appreciate performance reviews as much
as younger workers, but organizations must ensure the goals of older
workers meet the goals of the employer as well. Other options to retain
older workers may include training opportunities, reduced travel
commitments, and modified duties.
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"Develop a Plan, Prepare for the Baby Boomer
Retirement Surge"
WWJ Newsradio 950 (08/13/08) Cromie, Jenny
Many companies are preparing plans to deal with the retirement of some 78
million Baby Boomers from the workforce, but even more companies are not
fully prepared for the exodus. According to a recent Hewitt Associates
survey of 140 mid-size and large employers, only 55 percent of employees
have evaluated the impending impact of the Baby Boomer retirement, and only
61 percent have drawn up plans to retain those workers. Employers should
first examine the demographics of their workforce to understand how many
employees are near retirement, and then firms must devise programs to
retain older workers in some capacity or transfer their knowledge to
younger employees. Some of the strategies employers are considering include
mentoring where older workers are paired up with less experienced workers
for 12 months or more. Others are offering enhanced retirement packages
with medical benefits, and some employers are retraining older workers.
Employers currently favor the use of phased retirement, in which workers
have the option of a part-time schedule. Hewitt Associates Principal and
Senior Design Consultant Allen Steinberg recommends that employers
communicate with workers regularly to determine what benefits or programs
would keep them on the payroll, align programs with the needs of the
organization, and do not adopt programs that send the early retirement
message. Determine which skills must be transferred before older workers
retire and provide those workers with programs to accomplish that goal,
while at the same time offer training programs for older workers interested
in trying something new.
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"Groups Target Nursing School Bottleneck to
Address Medical Workforce Deficit"
Journal of the American Medical Association (08/27/08) Vol. 300, No. 8,
P. 887; Kuehn, Bridget M.
AARP, the Robert Wood Johnson Foundation (RWJF), and the U.S. Department of
Labor (DOL) recently came together to host a summit on improving the
development and retention of nursing program graduates. The three
organizations also published a white paper citing a number of local organizations
that created successful strategies for achieving this goal. The summit and
the white paper are part of an ongoing effort by the RWJF and AARP to solve
the prospective nursing shortage. The aging nursing workforce and the
general U.S. population continues to burden the healthcare industry and
increase the demand for qualified nurses. While higher salaries and good
long-term career opportunities have improved interest in the field, there
are simply not enough faculty and facilities in U.S. nursing schools to
accommodate qualified students. Over the next 12 months, AARP, RWJF, and
the DOL will attempt to alleviate this problem by providing technical
assistance to the 18 workforce groups chosen to take part in the summit.
One of the priorities of the groups is to ensure strategic partnerships are
created between corporations and stakeholders. These partnerships would
ideally increase the size and diversity of nursing school faculty, redesign
nurse education, and improve government and accrediting bodies' involvement
in program development. In addition to expanding nursing programs, the
organizations also are focused on improving nurse retention. They will
strive to improve nurse participation on boards of hospitals,
organizations, and programs.
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"P4P Money Slow to Come"
Modern Healthcare (08/18/08) Lubell, Jennifer
Hospitals participating in Medicare's Physician Group Practice
demonstration are not receiving the awards promised them for improving
quality standards and may abandon the methodology if bonuses are not
forthcoming. The U.S. Centers for Medicare and Medicaid Services (CMS)
partnered with 10 major healthcare practices for its four-year study and
offered payments in return for meeting performance benchmarks. The study is
set to end in March 2009, and half of the participating providers have not
received any bonuses due to an exception the White House Office of
Management and Budget slipped in once participants were already on board. The
hospitals agreed to stay on despite the White House's late-in-the-game
stipulation about reduced budgets; after several years in the program,
however, doctors say the targets are too onerous to meet. In the project's
second year, the 10 groups received $13.8 million in performance payments
for improving quality and efficiency and an additional $2.9 million from
the Physician Quality Reporting Initiative (PQRI) for tracking quality
measures. While all groups received a piece of the bonus from PQRI, the remaining
money was divided between the four groups whose actual costs fell below CMS
projections. The remaining six groups argue that improvements in quality
and efficiency lead to fewer payouts by CMS, and meeting the performance
benchmarks merits them a bonus.
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"Out of the Breach"
HR Magazine (08/08) Vol. 53, No. 8, P. 36; Zeidner, Rita
HR professionals have typically limited their role in data protection to
monitoring employee records. However, several recent high-profile security
breaches have some calling for an expanded role for HR professionals. Over
200 million personal records were incorrectly exposed to the public
beginning in 2005, and the number of annual breaches continues to grow. These
incidents include the 2006 theft of computer equipment from the U.S.
Department of Veterans Affairs, which exposed the personal information of
approximately 26.5 million people. Although employees and unions were
unsuccessful in court cases against companies that they alleged were
careless with personal data, HR professionals have other liabilities to
deal with, including state and federal fines. The U.S. Federal Trade
Commission has imposed millions of dollars in penalties to companies with
ineffective security and record handling procedures. Experts note that many
privacy breaches can easily be corrected because many stem from throwing
out unshredded documents and leaving confidential documents in a public
space. Experts recommend that HR professionals implement administrative,
procedural, and technical safeguards to prevent security breaches. HR staff
ensure individual workers are aware of what role they play in security,
which can be accomplished via training programs or confidentiality
agreements. In addition to minimizing the risk of a breach, a strong
training program could help a company avoid harsh fines in the event of a
security leak. Additionally, technology, including filters and monitoring
tools, can help an organization control access to data.
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"Preventing Sexual Harassment in the
Workplace"
Rough Notes (08/08) Vol. 151, No. 8, P. 70; Carter, Steve
Sexual harassment prevention in the workplace begins with a solid written policy
that outlines offensive behaviors and the procedures for dealing with them.
When drafting such a policy, a company must first define "sexual
harassment" as opposed to simple unwanted sexual advances or conduct.
According to the U.S. Equal Employment Opportunity Commission, a person is
the victim of sexual harassment if he or she must submit to unwanted sexual
demands or requests to keep their job, gain a promotion, or otherwise avoid
a hostile and intimidating working environment. The policy should be
tailored to include unique risks for a specific office and should include
information on how to report harassment and to whom. The company's CEO
should approve the policy and attach a cover letter to assure employees
that leaders at the highest level of the company take sexual harassment
seriously. Once the policy is in the hands of every worker, the company
should hold an initial mandatory meeting to go over the contents of the
policy. Experts recommend using this time to reinforce protocol for dealing
with general harassment or discord in the office as well.
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"Proactive Planning for Sharps Safety"
Materials Management in Healthcare (08/08) Vol. 17, No. 8, P. 26;
Chiarello, Linda
Prevention of sharps injuries is a complex task that should go further than
using safer devices and modifying behavior, and it requires hospitals to
implement a systemwide approach to prevention. Hospitals must engage
administrative staff in communicating the importance of worker safety and
utilize staff members and resources to ensure that safety objectives are
met. While infection prevention and control personnel use epidemiologic
skills to collect and analyze data on infections and identify priorities,
health and safety personnel collect injury information and determine which
environmental factors contribute to those injuries. Risk control
specialists can use their broader view to help design processes to prevent
injury in the future after examining how the current program is working to
prevent sharps injuries in accordance with U.S. Occupational Safety and
Health Administration regulations such as the Bloodborne Pathogen Standard.
Hospitals should ask who is at risk, why and what interventions are needed,
including the use of new devices, training upgrades or policy changes. The
areas for intervention should be prioritized, including troublesome devices
or procedures, and action plans regarding those priorities should be
implemented quickly. Finally, the team should continuously monitor the
program's performance and share results with all staff to keep their focus
on sharps injury prevention, ensuring that the organization never lets down
its guard.
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"Health Plans: Consumer-Driven Programs Fall out
of Favor"
Des Moines Business Record (08/31/08) Eller, Donnelle
With increases in health insurance costs of about 8.8 percent among Iowa
employers and employee, David P. Lind Associates discovered that many
companies are dropping high deductible plans in favor of ones with lower
costs. The number of Iowa employers offering consumer-driven health
insurance plans fell from 26 percent in 2007 to just 17 percent this year.
Despite support from the Bush Administration, consumer-driven healthcare
plans are losing ground nationwide due to average healthcare cost increases
of 10.6 percent, according to Aon Consulting. The Rand Corp. recently
reported that those employees with consumer-driven plans either used more
preventive healthcare services or delayed care because of higher costs.
Furthermore, experts contend the absence of consistent pricing information
for healthcare has made conscientious choices excessively burdensome for
many employees.
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"Cutting Employee Health Costs Encourages Them
to Manage Chronic Diseases"
Lynchburg News & Advance (VA) (09/04/08) Biflefeld, Marjolijn
Chesapeake Regional Medical Center and Chesapeake Public Schools will adopt
a new employee health insurance model that reduces the co-pays for items
related to chronic ailments. For instance, those workers with diabetes will
be encouraged to take care of themselves because the co-pays for test
strips and medication will be lower, and those with depression will be offered
free counseling. Chesapeake Regional Medical Center Director of Community
Health Services Beth Reitz says the hospital could see about $4 for every
$1 spent, reducing costs for diabetic patients by about $2,000 and reducing
the number of work days lost by half. While other employers adopting this
strategy note that initial implementation costs are higher, most posted
savings in the second year. As part of the program in Asheville, N.C.,
personal assistance and financial incentives were provided to diabetes
patients, including counseling from pharmacists on diet, exercise, and
medication. A number of employers are seeking alternative ways to reduce
healthcare expenses, but preventive care must be a component of any health
plan. However, experts agree that creating a "culture of
wellness" among workers is the best option, and employers should offer
employees incentives for good health habits and taking health risk
assessments.
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"Benefits Strategies for Retaining a
Multi-Generational Work Force"
Broker World (08/08) Vol. 28, No. 8, P. 10; Leopold, Ronald
Employee benefits are one of the most important factors in retaining
members of the workforce, according to annual employee surveys. However,
with four different generational groups in the workforce, one-size-fits-all
benefits programs are usually not effective. Technology, voluntary
benefits, and cafeteria plans can help employers offer their workforce more
flexibility and customization options. To offer the best benefits package,
employers must know what their employees want, which is why employee
surveys come in handy. Every year, employees of all ages and situations
rank health insurance as the most important employer-offered benefit. There
are other similarities between the groups, including a shared concern for
having enough money to provide for their child's college education, but
different generations have different desires when it comes to other aspects
of an employee benefits package. For instance, Baby Boomer employees
consider 401(k) plans or other retirement vehicles to be an important perk,
while younger employees are more concerned with extra paid vacation days
and dental coverage. In addition to understanding what the workforce wants,
employers need to be sure that they effectively communicate information
about benefits. While younger employees would be comfortable taking part in
a teleconference or webinar with an expert, older employees and employees
with new families are more likely to want to discuss their individual
situation with a benefit advisor or financial planner.
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"The Impact of Consumer-Directed Health Plans on
Prescription Drug Use"
Health Affairs (Quarter 3, 2008) Vol. 27, No. 4, P. 1111; Greene,
Jessica; Hibbard, Judith; Murray, James F.
Consumer-directed health plans (CDHPs) have become increasingly popular in
recent years, and recent enrollment estimates for 2008 have reached 12
million workers. Supporters of the plans claim that CDHPs can lower
healthcare costs by making employees responsible for purchasing their own
care. However, critics argue that CDHPs may push lower-income employees,
particularly those with chronic conditions, to forgo essential preventative
care. To determine the accuracy of these assumptions, researchers tracked
employees enrolled in CDHPs compared to those who participated in
traditional health insurance plans. Researchers discovered that when
compared to other enrollees, workers who participated in a high-deductible
CDHPs were two to three times more likely to discontinue antihypertensives
and lipid-lowering medications. Members of these plans also were more
likely to discontinue use of other drug classes. However, high-deductible
CDHP participants did not exhibit higher levels of generic medication use
than members of other plans, except in the case of anti-depressants. In
light of these findings, researchers suggest that employers using
high-deductible CDHPs educate staff members on the importance of generic drugs
and adopt procedures to prevent drug discontinuation among those workers in
need of medication. Recommended measures include usage monitoring, reduced
cost-sharing for chronic illnesses care, and exempting preventative drugs
from the plan's deductible.
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"Hospital to Improve Recruiting"
Wilkes Journal-Patriot (09/02/08) Williams, Charles S.
The Wilkes Regional Medical Center (WRMC) in North Carolina wants to establish
a partnership with the NorthEast Physician Network (NEPN) to bring more
hospitalists to healthcare centers in the city. As part of its short-term
recruitment strategy, WMRC formed the non-profit group Wilkes Physician
Network Inc. (WPN) to staff and operate various local physician practices.
A pending management service agreement between WPN and NEPN would allow the
former network to "lease" doctors from NorthEast to work in WPN
practices. NorthEast would manage finances, managed care contracting services,
and other administrative duties, while WPN would pay the hospitalists'
salaries. This arrangement would allow the Wilkes Physician Network to
establish a client base and offer new services not currently offered by the
city's providers. WRMC Interim Chief Executive Officer Fred Brown believes
the partnership would provide a strong employment model for young doctors
looking to open their own practices. "WPN, along with established
practices in the community, will serve as ways we can bring needed primary
care and specialty physicians into the community. [Physicians] also want to
concentrate on taking care of patients rather than managing what is
becoming a very complicated business," explains Brown. Members of the
Wilkes Physician Network hope the NEPN will use its leverage to hasten an
agreement so that doctors can begin working immediately in Wilkes
practices.
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Management and Leadership
"The Uncompromising Leader"
Harvard Business Review (08/08) Vol. 86, No. 7, P. 51; Eisenstat,
Russell A.; Beer, Michael; Foote, Nathaniel
Many executives struggle to balance the interests of their employer with
those of their employees, but there are some executives who have found ways
to do just that. CEOs for high-commitment and high-performance firms must
think beyond the bottom line and care about the well-being of their firm.
Executives able to motivate workers and maintain a healthy bottom line are
generally those that gained a majority of their management experience from
within the firm. These skills can help executives facing culture or
strategic changes at the helm of a company because legitimacy is one key
factor in the success of change management. Day-to-day operations must
remain a priority for these executives, which means personal connections
with individual employees are essential. Without these relationships,
workers can be taken for granted, which can translate into tougher times
when major culture or strategy shifts are necessary. To motivate workers during
these shifts, executives must foster honest and transparent communication
throughout the ranks prior to the strategy shift. Secondly, executives must
continually display care for the organization and its workers without one
taking precedence over the other. Through these techniques, executives can
create loyalty and trust to mobilize staff members. Executives also must
realize that they cannot change companies alone and will need the help of
other competent leaders, which may take time to cultivate.
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"Effective 360 Degree Management Enhancement:
The Role of Style in Developing a Leadership Team"
Organization Development Journal (Quarter 3, 2008) Vol. 26, No. 2, P.
89; Keeffe, Michael; Darling, Michael J.; Natesan, John R.
Leadership teams can play a valuable role in an organization, evolving into
a synergistic team where each member understands their own and others'
strengths and weaknesses. Differences in management styles can cause
frustration in an organization if individuals are unable to adapt to
co-workers with differing styles. The four styles are Analyzer, Director,
Expresser, and Relater. Analyzers tend to express low levels of
assertiveness and responsiveness, gathering and evaluating hoards of data
before making decisions. Directors express high levels of assertiveness and
low levels of responsiveness, meaning they are pragmatic and objective.
Meanwhile, expressers have high levels of assertiveness and responsiveness,
often seek the big picture, and develop creative and innovative management
approaches. Finally, relators are those managers and executives with low
levels of assertiveness and high levels of responsiveness who often are
sensitive to the needs of others and use empathy and understanding to solve
problems. Different situations call for different management styles, though
no one person can have all four styles because each style's strength is the
weakness of another. Effective leadership teams should include members who
represent all four management styles, though this could lead to conflict.
Style flex, however, can help managers interact and communicate more
positively by altering their level of assertiveness or responsiveness. The
ability to flex management style at a crucial time can help executives and
managers increase the productivity and satisfaction of a leadership team.
Experts indicate that the best scenario is when organizations are led by
executives or managers with complementary managerial styles wherein one
person's strengths compensate for the weaknesses of the other.
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