Process leadership and the death of management.

New information technology infrastructure allows point-of-service knowledge workers to make timely, informed decisions and take action without the traditional manager's close oversight or the top-heavy hierarchical structure associated with vertically managed organizations. Process leaders serve as consultants, coaches, linkers, and integrators to support front-line decision makers in a horizontally oriented model. The leaders must then be able to invest control, authority, and accountability for outcomes in the hands of the team. The process leaders, however, must be able to integrate resource information and generate knowledge and support for the providers of care that will enable them to make effective decisions about the requisite work. Process-oriented design in health care organizations emphasizes the interdependence of nurses, physicians, therapists, and technologists who must share the decisions and the risks. Thus, effective and efficient operations depend on recognizing the need for improved communications among team members and respect for the contributions of each.

Of mythspinners and mapmakers: 21st century managers.

The entire character of human experience is unfolding within an epochal change event as civilization shifts away from the Industrial Age. The U.S. healthcare system, rocked by the same dizzying rate of change, will play a pivotal role in the emergence of a new social contract. The coming transformation will require a revolutionary change in leadership style: the nursing manager really becomes a change agent--challenging, questioning the status-quo and creating an atmosphere where self-directed activities, workplace partnerships and shared clinical outcomes become the norm.