Appreciative leadership is thought to comprise four distinct components or attributes: it is relational, positive, capable of turning potential into positive power, and possessed of a ripple effect on all members within the organization, making a positive difference in the world.70 Developed around the framework of appreciative inquiry (which is examined in
detail in Chapter 5) appreciative leadership seeks to equate leadership with affirmation and to create an environment of organization-wide appreciation.71 Application of the
principles of appreciative leadership to the long-term care setting specifically seeks to address and overcome the long history of rewards and punishments discussed in Chapter 2 and to move the conversation and the culture to one of appreciation, support,
interconnectedness, and stewardship over both people and the organization. Whereas leadership practices that offer rewards and punishments are considered manipulative, those practices that define an appreciative approach seek to affirm and build upon the strengths that already exist within the organization.72 In a study of several healthcare
organizations in the Chicago metropolitan area for determining the effectiveness of appreciative leadership in various healthcare settings, researchers found that appreciative
leaders were self-aware, open to new learning, and willing to change the way they viewed certain issues based on feedback they received from their teams.73 Practices so critical to
the effective management of moral distress within long-term care are central to the leadership practices that now define appreciative leadership. These practices include eliminating silos within the organization and thus increasing communication, partnering with other departments to create operational synergies that would not otherwise exist, and developing business plans that serve to help each department minimize risks and
strengthen the overall operation.74 At the core of appreciative leadership is the notion
that there is more value to appreciating rather than judging in any given situation and to focus on developing strengths rather than on attempting to eliminate problems.75
A second study particularly relevant to the current discussion was conducted at the University of West of Scotland and built upon a previous study that examined compassionate care practices by staff, families, and patients of older adults in an acute care setting. Designed around the tenets of appreciative leadership, the goal of the one- year study was to provide the support and tools necessary for staff to work together to develop a culture wherein staff are encouraged to build upon current practices in a supportive environment and in which all levels of the organization—personal, team and organization-wide—respond positively to stakeholders (staff, families, and patients).76 In
stark contrast to the command-and-control (i.e., rewards-and-punishment) culture that has characterized many healthcare environments, this study sought to create an environment that encouraged leaders to develop relationships with their co-workers and patients that were nurturing, values based, and ultimately mutually beneficial.77 This program
purpose of coming to appreciate differing perspectives on common issues. Interestingly, the facilitators of the study sought to do things differently rather than simply do different things, thus allowing them to build upon existing strengths and to identify and address areas of opportunity. The emphasis of the study focused on relationship building and appreciation of one another’s work with the goal of delivering excellent care.78 At the
conclusion of the one-year program, staff reported increased self-awareness of their individual leadership capabilities; they reported learning new and effective methods of working with patients, families, and staff in a more cooperative, interdependent manner; and finally they reported developing new ways of building relationships which benefited them both personally and professionally. Finally, the authors wanted to stress the need for the organization to ensure that the organizational structure and systems were in place for supporting continued leadership development based on the appreciative leadership model.79 This study lends support to the current thesis by acknowledging the need to
address issues system-wide and supporting the necessity for organizational structures to be fully equipped to do so continually.
Whitney, Trosten-Bloom, Cherney, and Fry outline what they believe is essential for leaders to know if they wish to use an appreciative leadership approach in developing and maintaining a strong, effective team: leaders must develop clear goals and a
mechanism for measuring success, clarify areas of individual responsibilities and shared responsibilities, be clear that the work being conducted by the team members is carried out in a supportive manner and is relationship based, ensure that the procedures followed by the team are consistent and that information is shared freely by all team members, understand that the leader must be clear regarding how leadership is distributed
throughout the organization, clarify how will the team celebrate success, and be clear about how quality be measured and what standards will be used for measurement, and what methods of formal and/or informal communication the team will use.80 This
summary demonstrates that many of the areas noted are consistent with the Scotland study discussed earlier, particularly regarding the effectiveness of creating a supportive, relationship-based environment in which to address operational areas. When employees are free to engage with one another for a common purpose without fear of retaliation, the outcomes prove to be beneficial to both the individual and the organization. Appreciative leadership is said to generate commitment as a result of inclusion.81
Similar results were reported by Brooks concerning necessary operational improvements in a pediatric ward faced with high absentee rates, poor retention of staff, drug errors, and poor survey results. To confront these issues, Brooks implemented many of the appreciative leadership practices discussed above, including building the
confidence of the staff, providing opportunities for creativity in addressing issues, believing that the goals could be met, and persisting with goals through the change process. As results became evident, Brooks reported that staff attributed much of the success to the fact that they were actively involved in determining the course of action, that they in fact now “owned the dream,” and that they were now proud of their work and of where they worked.82
One of the most challenging aspects of working within any healthcare
environment is facing the oftentimes negative perceptions of the industry. Healthcare has become entwined in language focused on deficits and limitations rather than on all of the
of others.83 Given this environment, the role of the leader, and in this case of the leader
who espouses the tenants of appreciative leadership, is all the more critical to the success of the organization and to the individual employees within the organization. Cooperrider found that the appreciative leaders interviewed over the past 20+ years shared several common attributes or philosophies concerning their work. Appreciative leaders create their own reality; they are not brought down by the challenging circumstances in which they find themselves or their company. They approach their challenges with optimism, respect, and a positive intention to change things for the better. Appreciative leaders seek to expand the strengths and knowledge of all those they lead through a process of
constant inquiry and in building upon the strengths, observations, and ideas offered throughout every level of the organization. Finally, appreciative leaders understand the positive impact of inclusion at every level and seek full participation from everyone within the organization, recognizing that both the individual and the organization grow and benefit from such inclusion.84 Greeny et al. sum up all of the qualities of the
successful leader in one word: “influencer.” Their research on the commonality among successful leaders has led them to conclude that the most important skill of successful leaders is their ability to influence changes in the behavior of others—and, therefore, replace the term “leader” with “influencer.”85 While the terminology may be different,
the link between the appreciative leader and the influencer rests in the positive
interactions that these leaders bring to their organizations. Their willingness to devote time and interest to developing all members of their organization, in working towards common goals, and in being recognized for their individual and joint accomplishments all lend credibility to the title of appreciative leader.
2. Five Core Strategies of Appreciative Leadership: Inquiry, Inclusion,