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CHAPTER 11
FUTURE PULL Understanding the Culture in Culture Change by LaVrene Norton
full management team of up to 12 to 15 department heads regularly meet, generally not to make decisions but to share communications and be told by the execu- tive leaders what will happen next.
A step up from that is a model where leadership teams not only share communications but also partici- pate in making decisions. The leader might ask, “What are we going to do about this? You all work to find a solution and get back to me.”
PARTICIPATIVE MANAGEMENT
Participative management models engage all or many of the staff in decision making. It is difficult to include frontline staff when using this approach in large layered organizations that work around the clock. Con- sequently, in nursing homes we find that the opinions of managers and professionals (nurses, social workers, and dietary and activity professionals) are more often sought and valued. They may even be given occasional
assignments to make recommendations to the actual decision makers. This style not only looks friendly but also boosts morale and increases opportunities for good ideas to surface.
EMPOWERMENT
Perhaps next on this continuum is the model where the senior leader says, “I’m empowering you, and I want you, in turn, to empower frontline staff.” Basically this means that the leader will not make this decision; you are empowered to do so. However, the nature of long-term care work (highly compartmen- talized by licenses, certifications, educational require- ments) makes it very difficult to truly empower staff without first restructuring the organization to ensure that all decisions are attended to and that the deciders have the appropriate knowledge, resources, and criti- cal thinking skills to make informed decisions.
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