Emotional intelligence was a popular topic of leadership books and in management training and consulting in the late 1990s into the early 2000s. The Harvard Business Review printed its first article on EI in 1998. This followed the publishing of Dan Goleman’s book in 1995 titled, Emotional Intelligence: Why It Can Matter More Than IQ. Much has been was published on EI in business and leadership after that, and there continues to be a great deal of information on the topic. Healthcare has been slow to adopt EI into training programs for leaders and employees. According to Freshman and Rubino, this could be because healthcare providers feel that they are very compassionate and therefore don’t need to improve their emotional intelligence (Freshman & Rubino, 2002).
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Emotional Intelligence Defined
Emotional intelligence is the ability or tendency to perceive, understand, regulate, and harness emotions adaptively in oneself and in others (Mayer & Salovey, 1995). Emotional intelligence is not just about emotions or being nice to others. It is having the ability to say what needs to be said without losing control of the situation (George, 2000). It does not mean giving into all feelings, but expressing feelings appropriately and encouraging others to do the same. Emotional Intelligence is not genetic but learned and can be developed with practice and feedback. Freshman and Rubino state that these are skills to be developed rather than personality traits that are more concrete (Freshman & Rubino, 2002). Daniel Goleman describes five components of EI: self-awareness, self-regulation, motivation, empathy, and social skill (Goleman, 2004). Leaders and employees who have these traits can have a very positive effect on their organizations.
Understanding moods, feelings, and emotions and their effect on others is crucial to having emotional intelligence. Leaders need to understand that their mood is reflected on the mood of their followers. A leader that avoids interaction with employees when in a bad mood can destroy trust and cause uncertainty within the group (George, 2000). Conversely, a leader who can excite and motivate his or her followers will build trust and improve the team’s ability to work together (George, 2000).
Why Emotional Intelligence is Important in Health Care
As previously stated, EI in healthcare is relatively new. For the most part, health care providers choose their career path because they want to help people. They are caring and compassionate people by nature. However, caring for patients has always been stressful. In addition, the health care industry is under constant scrutiny with new regulations under the Affordable Care Act, a growing number of uninsured patients, and changes in reimbursement to include value-based purchasing (Fuguy, 2012). Health care providers report high levels of perceived stress leading to mental health problems as well as drug and alcohol use (Fuguy, 2012). Employees who are emotionally intelligent are able to cope with stress positively and tend to be calmer than their counterparts. They tend to be more optimistic and are more satisfied with their life and their work (Fuguy, 2012). An optimistic, upbeat health care provider would be happier at work, have a better attitude, and would tend to have higher patient satisfaction scores as a result (Freshman & Rubino, 2002).
Self awareness. Leaders in healthcare need to have a solid understanding of their own emotions and how they affect others. With that knowledge, these leaders will be able to make difficult decisions with regard to budgetary restraints and will then be able to explain to their followers why the cuts had to be made. They will be able to recognize and promote work/life balance for their team members and for themselves (Freshman & Rubino, 2002). They will be calm under stressful situations and will be able to help others remain through difficult situations. Self-aware leaders are open and honest about their feelings and allow their followers to share their feelings. They are considered approachable as well as dependable in a crisis. Leaders who have little to no self-awareness may project stress, be defensive or demanding, and will fail to notice how their leadership affects others (Fuguy, 2012). Displaying self-control can be a powerful role model for employees.
Self-regulation. Leaders with an ability to adapt to changes without being impulsive will seem patient and understanding to their followers. Individuals with good self-management skills tend to be sensitive but direct and are usually well-equipped to handle stress. They are polite and professional despite the worst of circumstances (Fuguy, 2012). These leaders know when to step out when tensions get high in order to diffuse a situation. They also accept responsibility for their actions and the actions of their team (Freshman & Rubino, 2002). Leaders who lack self-regulation may respond too quickly or sharply and may panic in a difficult situation. They may have verbal or emotional outbursts displaying their stress to their followers. This then increases the stress on the team and can lead to mistakes in patient care. They may also share negativity with followers or colleagues and this could negatively impact a patient’s perception of care (Fuguy, 2012).
Motivation. Leaders who are self-motivated are driven to achieve and are passionate about their work. They enjoy challenges and usually volunteer for additional duties. A motivated leader will be optimistic when census is low therefore easing the concerns of his or her team (Fuguy, 2012). This type of leader would seek out opportunities to resolve conflicts in order to maintain an environment of trust and cooperation (George, 2000). In the current climate of healthcare reform, motivated leaders will be well-positioned to lead the charge for change.
Empathy. Empathy is the ability to see the world from someone else’s perspective regardless of your own perception (Fuguy, 2012). Leaders who are empathetic can truly recognize how another is feeling. These leaders are able to thoughtfully consider their employees’ feelings before acting. They are compassionate when dealing with employees’ personal problems that might affect performance but not to the detriment of the department as a whole. Empathetic employees in health care will consider the patient and family’s perspectives when making bioethical decisions (Freshman & Rubino, 2002). Schutte, et al, showed a high correlation between emotional intelligence as measured by the Interpersonal Reactivity Index and empathy (Schutte, Malouff, Bobik, Coston, Greeson, Jedlicka, Rhodes & Wendorf, 2001).
Leaders need to encourage and foster empathy in order to truly achieve patient-centered care. They can train their followers in the ability to read emotions as they provide for the needs of others including the patients. Change is more likely if experience is shared and followers understand that everyone is working together. Showing concern for the feelings of others and caring for their needs leads to better cooperation and work performance and eventually improved outcomes in healthcare (Fuguy, 2012).
Social Skill. Health care administrators will be crucial in the next few years as the Affordable Care Act is fully implemented. Leaders will need the social skills to effect change while maintaining employee engagement and patient satisfaction. From negotiating a favorable managed care contract to presenting new ideas to the governing board, leaders must be able to influence others (Fuguy, 2012). Today’s healthcare administrators must inspire their employees to put the team’s interest ahead of their own and encourage followers to “weather the storm” of transformational change (Sosik & Megerian, 1999).
Emotional Intelligence of Groups
In healthcare today, emotional intelligence is vitally important among leaders. However, all employees need to improve EI as they work to improve patient satisfaction and outcomes. But having emotionally intelligent team members does not always mean an emotionally intelligent group. In order for a high functioning team to thrive, the environment must be one of trust and emotional situations must be dealt with constructively. Emotional incompetence can cause dysfunction in groups if steps are not taken to improve the EI of the group and its individual members (Urch Druskat & Wolff, 2001).
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On any given day within a team, any member may have a bad day or exhibit negative emotions. However, in high functioning teams, the members will recognize the behavior and will address the emotional needs of the individual in a supportive and constructive manner (Urch Druskat & Wolff, 2001). An example occurred on a team at Hewlett-Packard:
We learned of a team that was attempting to cross-train its members. The idea was that if each member could pinch-hit on everyone else’s job, the team could deploy efforts to whatever task required the most attention. But one member seemed very uncomfortable with learning new skills and tasks; accustomed to being a top producer in his own job, he hated not knowing how to do a job perfectly. Luckily, his teammates recognized his discomfort, and rather than being annoyed, they redoubled their efforts to support him (Urch Druskat & Wolff, 2001).
Individual self-awareness and awareness of the emotional needs of the team can build confidence and trust within the group. Seeing the needs of each team member from an individual member’s perspective allows for cooperation and collaboration in a safe environment (Urch Druskat & Wolff, 2001).
Transformational Leadership and Emotional Intelligence
“Transformational leaders are those who stimulate and inspire followers to both achieve extraordinary outcomes and, in the process, develop their own leadership capacity. Transformational leaders help followers grow and develop into leaders by responding to individual followers’ needs by empowering them and by aligning the objectives and goals of the individual followers, the leader, the group, and the larger organization (Bass & Riggio, 2008).” Components of transformational leadership are idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration (Barling, Slater & Kelloway, 2000). Sivanathan and Fakken found that leaders with high self-reports of EI are perceived by their followers to have greater transformational behaviors (Sivanathan & Fekken, 2002). These leaders motivate and empower their employees utilizing reward and recognition and by challenging them to achieve their personal best. Leaders who can recognize and control their own emotions and maintain self-control are strong role models. This is the essence of idealized influence. Leaders who are highly motivated themselves can inspire their followers to achieve greater heights, again, by modeling that behavior. Individualized consideration is the ability to pay attention to the problems, emotions and needs of an individual. Emotionally intelligent leaders with strong empathy would be able to be attentive to the needs of their followers and their team as a whole. Empathy would also allow leaders to assess the intellectual needs of their team members and encourage active participation and stimulation (Barling, Slater & Kelloway). EI and transformational leadership go hand-in-hand toward effective change management in today’s health care leaders.
Becoming emotionally intelligent leaders
Understanding the importance and value of emotional intelligence is the first step. Leaders must embrace the need for improved interpersonal skills in themselves and their followers. Freshman and Rubino suggest four steps for implementing EI in a health care organization: (1) preparation, (2) training, (3) transfer and maintenance, and (4) evaluation (Freshman & Rubino, 2002).
Initially, assessments need to be conducted to determine the needs of the organization as well as the personal needs of individual leaders. Participation is imperative and must be encouraged. The needs of the organization must be aligned with the goals and values of the organization in preparation for the next step. Training involves beginning the process of building rapport between the trainer and participants. Goals and expectations must be clearly stated and understood. Participants should be encouraged to actively seek out opportunities to practice and receive feedback. The third step involves continuing to practice the newly learned techniques and receiving feedback so as not to fall back into old habits. Finally, the fourth step requires assessing the progress and providing additional feedback for continual progress toward the goals (Freshman & Rubino, 2002).
Strong emotions can often interfere with intelligent behavior, making emotional intelligence seem like an oxymoron. However emotions can also be strong motivators for action and can lead to a passionate pursuit of a goal. Leaders with emotional intelligence should be highly sought after in the health care industry. These leaders will be able to inspire and motivate their followers to maneuver the constantly changing world of health care that will be under increased scrutiny and regulation in the years ahead.
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