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Review the document, ACHE Healthcare Executive 2019 Competencies Assessment Tool (Wk4.3 file attached)Assess whether you meet the ACHE leadership competencies. Then,
recommend at least three strategies to better meet competencies by
building on your strengths and improving your weaknesses. Defend your
recommendations. Support your response by identifying and explaining key
points and/or examples presented in the Learning Resources.


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Temmuz-Ağustos-Eylül 2014 Sayı: 15 Cilt: 5 Yaz Dönemi
July-August-September 2014 Issue: 15 Volume: 5 Summer Term
ID:398 – K:417
Fatih BUDAK1, Ahmet KAR1
Hacettepe University, Institute of Social Sciences, Department of Healthcare Management
Abstract: Healthcare Sector which has a complicated system even in the simplest term is getting more
complicated through handling it in a national level and in a worldwide dimension. At this point, it is getting harder to manage this complication in a managerial sense. With the developments in international
dimension, healthcare management sector which is no more an ordinary service sector cannot stand idle
by these developments and day by day it has gained a more professional structure. Terms such as patient
rights, quality, internal and external customer satisfaction, strategic management and leadership have
been in the focal point of modern-day healthcare management, and health institutions which keep up
with the times need professional managers which are competent in work and have features of strategic
management and leadership.
Key Words: Healthcare Management, Strategic Management, Strategic Leadership
Serious troubles have caused in terms of management
in health sector because of extreme workload in
healthcare, over competition in health sector, lack
of available staff who has different qualifications
from each other but works within the scope of
mutual attachment; the necessity of following up
developing technology in this sector in order to
give more qualified service and –above all- the
fact that all services done are related to human
health. For this reason, providing services in health
institutions working in an utmost complicated
system continuously can only be possible with
both managing strategically health institutions
in an effective way and team-work in which
the managers of institution will create in focus
strategic leadership qualifications.
Objective: The objective of the study is to find
out the necessity that health institutions which
are at the focal point of individual and social
development should be managed by managers
having strategic leadership qualifications, and to
bring forward solution proposals about this issue.
Scope: National and international literature studies,
conducted within the scope of strategic management
and leadership about the management of health
institutions create the scope of this article, and
the analysis of academic information related to
Temmuz-Ağustos-Eylül 2014 Sayı: 15 Cilt: 5 Yaz Dönemi
July-August-September 2014 Issue: 15 Volume: 5 Summer Term
ID:398 – K:417
the subject in this scope has been presented to
concerned with the management of works which
can make possible for the business to continue
its operations in the long term and can provide
the business with a competitive advantage and
much return than average profit. On the other
hand, the term ‘leadership’ is described as a
concept which existed since human beings have
lived together and whose beginning goes back a
long way in terms of historical process (Bakan,
2008). For this very reason, the answers to the
questions – ‘What is leadership?’ and ‘What are
the kinds of leadership? – are at least as many
as the number of people asking these questions
(Stogdill, 1974). Further to this, there are still
lots of unknown things about leadership although
thousands of studies conducted about leadership
give important information about what leadership
is or not. (Ivancevich ve Matteson, 2002).
Method: Literature review was made and information
acquired by probing scientific works related to
the issue was analyzed and interpreted from the
point of scientific view.
Research Questions: The research tries to answer
these two questions: What is the significance level
of common strategic management and private
strategic leadership concepts for managers of health
institutions in the healthcare system of Turkey
which is a sub-sector of international healthcare
sector in modern world, and international health
system? What are the systemic and scientific
works conducted about this issue and what
should be done?
Theoretical Framework and Limitations:
Management, Strategic Management, Leader
and Strategic Leadership concepts were primarily
discussed in the study, and then Strategic Leadership
Concept was studied in details. In part four, studies
conducted about the importance of Strategic
Leadership in Healthcare Management were
presented through analysis. In the conclusion part,
suggestions, solution proposals were presented for
national and international health system focusing
on healthcare management.
Healthcare sector has been in a period of change
devoted to improvement in both our country, other
developed and developing world-countries. In
particular the rise of expectation for competition
in this sector and for health quality has revived the
issue of autonomizing and discommoning even
public hospitals in our country, and autonomy
in terms of managerial was provided to public
hospitals by founding Association of Public
Hospitals with the statutory decree about the
organization and functions of the Ministry of
Health and subsidiaries on 11 October 2011.
These works show that strategic management
and leadership concept are indispensable factors
of specially healthcare management. Because
it is known that leader behaviors of managers
in charge of health institutions, which provide
people with job and where people endeavor too
much, have clear influence on job satisfaction
According to Ülgen and Mirze (2010), strategic
management is a term which expresses a more
clear expansion of business management due to
the intra-word ‘management’. However, strategic
management is not concerned with the management
of daily and ordinary works of business, but
Temmuz-Ağustos-Eylül 2014 Sayı: 15 Cilt: 5 Yaz Dönemi
July-August-September 2014 Issue: 15 Volume: 5 Summer Term
ID:398 – K:417
of workers and on organizational commitment
(Güldaş, 2009).
2.1. Manager Concept
According to Koçel (2011) we can describe
‘Management’ as an occupation and ‘Manager’
as the person who does it. In other words, it is
an occupation of reaching their goals of business
units by using fund of accrued knowledge in
management domain, working with others and
transacting business via these. If we define
‘manager’ concept according to open system and
contingency approaches, manager is a person
whoever gathers factors of material and humane
production canorously in order to achieve certain
objectives in period of time and under variable
ambient conditions (Eren, 2011). Operations done
in an organization can be big or small. There are
managerial levels from the bottom level (operational
level) to the upper level (strategic planning level)
in business firm. Thereby, managers are not the
ones who just conduct important and big works.
Hence, managers at each level, including human
beings are responsible for making the business
achieve needed and intended goals by utilizing
available sources efficiently and productively
(Ülgen ve Mirze, 2010). Based on these definitions
we can say that manager is a basic humanistic
element who neatly implements operations (at the
same time who also takes responsibility) towards
organizational goals by applying available rules
thanks to the authorization given to him or her
legally (Güney, 2007). According to Ülker (1997),
the qualifications which a manager should have
are listed as follows:
The manager is;
• who manages
• who maintains order
• who is a protector
• who is system and organizastion-centered
• who is prone to control
• who has tunnel vision
• who cares about ‘how and when’ questions
• who has vision about sub-managerial stages
• who is prone to accept available situations
• who transacts in compliance with permanent
• who does his job systematically
2.2. Leader Concept
One of the basic concepts of post-modern and
contemporary approaches is ‘leader concept’. The
concepts such as organizational overcast structure,
applications of empowerment, organization within
teamwork (group) and acquired authority brought
‘leader concept’ to forefront instead of ‘manager’
who uses formal authority virtually based on the
position (Koçel, 2011). The word ‘leadership’
frequently used in the last two centuries took part
in world literature in 14th century (Stogdill, 1974).
Although lots of studies have been conducted
about leadership and especially leader concept,
they are the concepts which mankind barely
build consensus about their definition and content
(Ergen, 2011). For this reason, researchers’
definitions of the leader by considering different
variances through their personal point of view and
interests caused lots of definitions in literature.
Temmuz-Ağustos-Eylül 2014 Sayı: 15 Cilt: 5 Yaz Dönemi
July-August-September 2014 Issue: 15 Volume: 5 Summer Term
ID:398 – K:417
Leader is defined in three different meanings in
the dictionary of Turkish Language Association.
The first meaning is pioneer, commander; the
second meaning is someone who is in charge of
top management of a party or institution; and the
third one is a team or person who takes the lead
in a contest (TLA, 2014). According to Koçel
(2011), leader is the one who motivates others
to behave in accordance with certain goals and
influence them. In another word, leader is the
one who a group of people follow in order to
achieve their personal and group objective, and
whose desire, command and instructions lead
those people. According to Barlı (2010), the
qualifications and features a leader should have
are sorted below:
• Being humble and tolerant
• Not repeating mistakes and learning from
• Making the right decisions
• Being neat in private life and respectful
2.3. The Differences between Manager and
The concepts of manager and leader are two
important concepts of management domain
which are muddled up with each other, are used
interchangeably, but not the same as each other.
According to Kotter (1999) management and
leadership are a system of two separate and
component actions. Each of them has distinctive
function and characteristic engagements. In today’s
competitive and active business climate both of
them are necessary for success.
• Being charismatic
• Having vision and mission
• Being strong in all respects
Management is related to an organization’s
continuation and its hierarchical structure, and
within the scope of this concept it fulfills functions
such as planning, organizing, coordinating,
orientating-guiding and controlling. On the
other hand, leadership is related to getting into
the act and acceleration of change (Drafke and
Kossen, 1998).
• Being enterprising, innovator and creative
• Being ambitious and spirited
• Being able to communicate effectively
• Being positive
• Being faithful
While leaders are the ones who are pioneers of
big plans and have ideas, managers are the ones
who apply these plans. In another word, manager
is the one who carries out the vision of a leader
(Ülgen and Mirze, 2010).
• Having the ability of rhetoric and persuasion
• Trusting and being reliable
• Having general knowledge
• Being brave, patient and calm
Kotter (1999) points out that management is to
cope with complexity, and leadership is to adopt
• Being determined and consistent
Temmuz-Ağustos-Eylül 2014 Sayı: 15 Cilt: 5 Yaz Dönemi
July-August-September 2014 Issue: 15 Volume: 5 Summer Term
ID:398 – K:417
a personal and effective attitude which is goaloriented while linking leadership with handling
the change and stating that managers are nonpersonal and passive about goals.
The differences between manager and leader
can be summarized as seen in the table below
when literature search is done about the issue
(Güldaş, 2009).
According to Yukl (1989), one person can be a
leader without being a manager and one person
who is not a manager can be a leader, too.
Table 1. Differences Between Leader And Manager
The manager applies
The leader innovates.
The manager maintains continuity
The leader develops.
The manager is based on regularity.
The leader is based on persons.
The manager relies on supervision.
The leader relies on persons.
The manager does the works right.
The leader does the right works.
The manager preserves.
The leader develops.
The manager imitates.
The leader brings the new out.
The manager asks ‘how’ and ‘when’ questions.
The leaders asks ‘what’ and ‘why’ questions.
The manager tends to adopt non-personal
managerial goals.
The leader tends to adopt persons and active
The manager uses his works as integration
process of human and material sources.
The leader improves people’ ideas about
possibility and necessity.
The manager uses tactics such as agreement,
punishment or rewarding.
The leader reveals new moral values and creates
special desire and goals via commands the leader
The manager acts through incentives to protect
what exists, and stays away from taking risk.
The leader prefers to create ambition at work,
and keep opportunities and awards at high level.
Reference: Güldaş, 2009
The word ‘strategy’ etymologically comprises
of the combination of two old Greek words as
root and prefix. It derived from the word ‘stratos’
which means a spread army or a large community,
and the suffix ‘egy’ in this word means ‘direct’
(Adair, 2002).
According to Turkish Language Association (2014),
the word ‘strategy’ whose meaning is ‘izlem’ in
Turkish came from French into Turkish and has
been used in social sciences since 1970s. In
the dictionary of Turkish Language Association
(2014), the word ‘strategy’ means the science and
art of using politic, economic, psychological and
military powers concomitantly for the purpose
of supporting policies adopted of a nation or a
community of nations in peace and war time. At
the same time, the word strategy which has been
Temmuz-Ağustos-Eylül 2014 Sayı: 15 Cilt: 5 Yaz Dönemi
July-August-September 2014 Issue: 15 Volume: 5 Summer Term
ID:398 – K:417
used as a military term for centuries is defined in
Webster’s New International Dictionary (2014) as
follows: the science and art of military command
exercised to meet the enemy in combat under
advantageous conditions.
organization at the same time are needed (Industrial
College of the Armed Force, 2002).
Strategic leadership which is one of the important
components of strategic management process is
defined as abilities of divination, creating vision,
providing flexibility, thinking strategically and
working with others in order to initiate changes
which will provide a feasible future for organization
(Uğuroğlu and Çelik, 2009).
According to all these definitions, strategy
comprehends precautions and regulations taken
to achieve objectives in general. In this context,
strategy can be interpreted as the way which all
organizations will follow in order to maintain its
existence and increase efficiency (Güçlü, 2003).
Ireland and Hitt (2005) define strategic leadership
as a person’s ability to anticipate, envision,
maintain flexibility, think strategically, and work
with others to initiate changes that will create a
viable future for the organization. On the other
hand, Rowe (2001) defines strategic leadership as
the ability to influence other to voluntarily make
day-to-day decisions that enhance the long term
viability of the organization while at the same
time maintaining its short term financial stability.
The basic duty of a leader is to create strategies
in order to carry out the mission or basic goal
of business by specifying them. The strategic,
an important factor in succeeding in fulfilling
strategies, is the person who can make strategic
changes via his abilities of vision, anticipation,
being flexible and impowering other followers
(Ülgen ve Mirze, 2010).
In general terms strategic leadership is concerned
with all people taking on all responsibility of
organization ; it is also concerned with people
such as top executives, dominant coalitions inside
the organization, board members and general
managers of departments (Boal and Hooijberg,
200; Hitt et al., 2007).
In order to understand the concept of strategic
leadership better, the differences between it and
leadership should be presented clearly. The duties
laid on the leadership concept differ according
to available hierarchal levels in especially big
organizations. For instance, strategic leadership
dominates in the top levels of organization,
organizational leadership dominates in the medium
levels, and apprehension of leadership focusing
on production and action dominates in the bottom
levels of organization. In this dispersion leaders
in the top level are responsible for determining
strategic tendency and vision of organization
within the scope of global strategic environment.
Not only analytical thinking is needed for leaders
in this strategic level, but also creative thinking
manners to develop the vision and mission of
3.1. The Emergence of Strategic Leadership
When situations which businesses faced in 1960s
and 1970s are considered as the key determinant of
managerial behaviors and organizational outcomes,
the studies about leadership have shown a change
from managerial leadership studies to strategic
leadership studies since the middle of 1980s;
and hence, it has shown a change towards top
Temmuz-Ağustos-Eylül 2014 Sayı: 15 Cilt: 5 Yaz Dönemi
July-August-September 2014 Issue: 15 Volume: 5 Summer Term
ID:398 – K:417
executives (Ireland and Hitt, 2005; Yukl, 2002).
The first marks of this change can be seen in
Upper Echelon Theory by Hambrick and mason
(1984). Thereby, the theory of strategic leadership
derived from upper echelon theory and developed
(Vera and Crossan, 2004).
Strategic leadership theory considered organizations
as a reflection of specially CEOs (Chief Executive
Officer) and many CEOs accepted strategic leadership
responsibilities on their own. The basic duty of
CEOs as the strategic leaders of organizations is
to choose a vision for their organizations and to
provide necessary conditions to be able to reach
this vision. In particular when these choices end up
with success, strategic leaders in the key position
are declared as ‘hero’ in companies they work
for (Uğurluoglu, 2009).
In 21st century global and big rivals took the
place of local and small rivals on the basis of
companies with the influence of globalization;
sense of competition changed. And hence, strategic
leadership’s perception and practices changed by
being out of control of only one person about the
issue of determining the future plan and vision of
organization. In table 2, as a statement of these
changes, the strategic leadership practices of 20th
and 21st centuries can be seen (Ireland and Hitt,
2005; Uğurluoglu, 2009).
Table 2. Strategic Leadership Practices
20th Century Practices
21st Century Practices
Outcome focused
Outcome and process focused
Stoic and confident
Confident, but without hubris
Sought to acquire knowledge
Seeks …
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