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      Strategic Management and Leadership for Health Professionals — Skills To Leverage Resources To Achieve Health Goals


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          Introduction The recent approach to healthcare considers the broader determinants of health to improve population health. One is able to positively impact health goals only when these are addressed through multi sectorial coordination.(1) Marc Lalonde in 1974(2) was among the firsts to elaborate the need to look beyond health care organizations to impact health. His report paved the way for an international debate on the role of non-medical determinants of health, including individual risk behavior setting the tone for a new public health discourse and practice in the decades to come.(3) Lalonde's framework groups health determinants in four areas [Figure 1]. There are different weightages assigned to contribution of the four areas to population health. Behavior contributes to around 50%, Environment around 20%, Biology around 10% and health care 20%.(4) There is no data from developing countries on contribution to health by these four broad areas but environment with lack of safe water, sanitation, lack of safety standards at work place and home is likely to be a larger contributor to health. Health system is certainly not a major contributor to population health. Figure 1 Four domains of determinants of population health While the traditional patient-health care provider driven approach held the health professional within the realm of health sector where the majority of time was spent to operationalize mechanisms for disease-centered care. Rampant surge of non-communicable diseases requires a boarder action that promotes good health. The current disease scenario seeks the health professional to look beyond the health sector. After achieving the eradication of small pox, polio and elimination of Guinea worm, and substantial reduction in HIV/AIDS, Leprosy etc. in India, it is now required to move ahead and look at health in a comprehensive manner to achieve sustainable and equitable improvement in health. In India, non-communicable diseases (NCD) account for 60% of deaths followed by communicable, maternal, perinatal and nutritional diseases (28%) and injuries (12%).(5) The root causes of all these diseases are - lifestyle and pollution for NCDs; inadequate water and hygiene etc. for communicable diseases; malnutrition, illiteracy and lack of resources to access timely health care for maternal child health conditions; and unsafe vehicles, houses and road conditions for accidents. It is clear that prevention of deaths in all four major groups of diseases can be done only if other sectors are adequately engaged and the health sector is involved in providing excellent medical care. Thus, the new approach requires policy makers across all sectors to be realize the consequences of their decisions on health and be accountable for population health.(6) Similarly, health ministers, policy makers, health systems scientists, program implementers and other health professional should actively engage with other sectors while continuing with efforts in traditional disease control approaches. It demands for a new skill set where the health professional in his new role interacts with key influencers in other sectors to make decisions that do not lead to ill health and improve health. Influencing others, identifying windows of opportunity, art of advocacy, negotiation and networking form the key skills for a health professional to achieve health goals through multi-sectorial efforts. Last thirty years have also seen a global surge to use health promotion approach to improve health. Health Promotion can be used effectively to address both communicable and non-communicable diseases by going beyond boundaries of health sector.(3) Influencing Others As one moves up the ladder of leadership, one's priorities need to shift from doing own work to managing team and spending more time in networking. In public health, the team leader interacts with other health professionals, bureaucrats, politicians within the Ministry of health and other ministries. One is required to influence and convince them to be able to generate interest in health and actions required. This also gains prospects for his team to positively impact policy making or implementation of a program to improve health of the population. This helps in better planning and execution where the team's goals are aligned with the current needs of the society. In addition to technical knowledge and analytical skills, good communication skills and networking help in advocacy. The ability to visualize future scenario, identify windows of opportunity and negotiation skills further drive the leader towards success. Identifying windows of opportunity Identifying windows of opportunity is the key to influence the policy environment and decision makers within and outside the health sector. A leader should identify opportunities, take advantage of these and engage in activities involved to achieve goals. Some examples of such opportunities in India are presented below: The New health and education policies are being drafted. These present several opportunities to engage people from various organizations/capacities to provide inputs, especially on the role and responsibilities of other sectors in improving health. Like education Policy should include healthy life style education in school children. Pre-service and In-service training of bureaucrats, public health professionals, social sciences and related sectors. New legislations: New Public Health Act being drafted Outbreaks: Any outbreak of disease gets more attention of politician, bureaucrats and media for example, water borne diseases such as Polio, Dengue, Jaundice, Cholera can be used to leverage action in water supply and sanitation; Flu to promote hygiene and dengue to mobilize municipalities, corporations and local self-governments for health starting with elimination of mosquito breeding within and outside households etc. Professional bodies of health and related professions: The potential of these professional bodies is underutilized. They hold regular conferences and bring out journals where these aspects can be highlighted especially in the sessions attended by politicians and bureaucrats. Political agenda: ‘Swachh Bharat Abhiyan’, for example, is an opportunity to push for universal safe water and sanitation and will go a long way in preventing common diseases. ‘Swachh Hospital Abhiyan’, as part of this campaign builds on this opportunity to eliminate hospital acquired infections. Health Impact Assessment unit needs to be established in the Ministry of Health and Family Welfare and empowered to review the impact on health of all projects in all other sectors Advocacy Advocacy is essential for every health professional to promote effective interventions to address public health problems. Advocacy is the act of pleading or arguing in favour of something. It highlights to change the “what is” into a “what should be".(7) It is a process adopted by an individual or a group to influence policy and resource allocation decisions within political, economic, and social systems and institutions. Advocacy can include many activities that a person or organization undertakes including media campaigns, public speaking, publishing research etc. The information for advocacy can be packaged in many ways including the following depending on the audience: Press Release, Fact Sheet, Power Point, Website/Internet, Television/Radio spots, Article in newspapers, magazines, Research Update, Policy Brief, White paper, Talking Points, research Summary, Publication in Journal etc. One opportunity often missed is short encounter with an important person such as a minister or a top bureaucrat. We can use these opportunities to convey a message effectively. This is often referred to as ‘one minute’ message. A one-minute message includes: The statement of the issue, Evidence to support the issue. An example of the problem, the desired policy action ideally, only one main point should be communicated or, if that is not possible, two or three points at the most. Negotiation Negotiation is a common everyday activity from birth till death. It is a process by which we attempt to influence others to help us achieve our needs, while at the same time taking others’ needs into account. It is a fundamental skill, not only for successful management but also for successful living. This important skill is essential while negotiating to include health action in other sectors.(8) The suggested steps for a successful negotiation: Identify your own goals, priorities and bottom-line before you negotiate Identify your strong points and weak points in negotiation Find out and understand other person's or party's agenda and priorities. Try to accommodate these without compromising on yours. Clear message of what you want and why? How it will best appeal to the person you are negotiating with. Identify the possible outcomes and practices to deal with unfavorable outcome Be prepared to deal with deadlock by revisiting your own priorities and other person's priorities and start with pointing out areas of agreement and move to negotiate areas of disagreement. Networking Networking is a force multiplier in your advocacy efforts to achieve your professional and personal goals. You can do much more through your effective, relevant contacts in your network if you cultivate and sustain it. Networking is the exchange of information or services among individuals, groups, or institutions; specifically: The cultivation of productive relationships for employment or business.(9) Ability to network is becoming more and more important. Maintaining good relations fosters trust and fidelity commitment.(10) Virtual Networking: Internet has made networking very easy. Various professional and social networking sites such as Linkedin, Facebook, Researchgate, Blogs, Twitter and e mail need to be used effectively to reach out those in your and your contacts network easily and fast to communicate and mobilize like-minded persons and groups. These networks help in: Establishing new contacts (both individuals and groups). Keeping in touch with old contacts especially those in distant places in other cities and other parts of the world with whom you may not be able to maintain face-to face contact. Researching potential contacts who may add value. Face to face Networking: Strong way of making new contacts and effectively maintaining old contacts. Attributes that help in networking: Listening skills focus on others, empathy and intimacy Understanding body language: Ability to observe and interpret body language of others Open attitude to new ideas which should also be reflected in body language during the interaction with others. Creating a positive atmosphere: According to Market Watch, more than 85% of success comes from the ability to create good atmosphere and only 15% from professional competence. Practice and deliver an effective message in short time say in one minute or a small talk to cash in the opportunity of casual short encounters with influential persons such as a politician or a bureaucrat. Networking is an arrangement where several individuals or organizations share a common interest. The main activity is information sharing and facilitating. Well-functioning networks usually have an efficient “node” or secretariat. There are three forms of networking. The first helps manage current internal responsibilities, the second boosts personal development, and the third opens one's eyes to new directions and the stakeholders one would need to enlist [Figure 2].(11) Figure 2 Three forms of networking based on what you want to achieve Netweaving Networking has long been cited as an effective means of making new professional contacts and as a way to expand career horizons. Now there's a new twist to this long time career tool-Netweaving. Netweaving is a concept focused on more effectively developing reciprocal business relationships that has far-reaching potential. In Netweaving, the focus is on “How can we help each other?” and the approach is more relaxed and reciprocal.(12) Other Important Skills/Concepts Three pillars of leadership It important for leaders in health care to continuously upgrade their skills in three domains which are Technical: The health sector is dynamic and it is important for a leader to keep updating his technical knowledge. Cognitive: A leader is required to learn new skills to deal with technological advances and keep pace with emerging technology such as using social media to strengthen and retain his networks. Emotional competencies: Emotional competencies contribute to improved professional performance and determine success in life. It also important for one to have a good family and social relationship.(13) Emotional competencies can be learned at any age in life. To be a successful leader one needs to regularly review one's emotional competencies and improve these by learning from interactions one could have done better. Managing difficult colleagues One always comes across people who are difficult to deal with. A leader has to get work done from all his team members, hence must deal with such people effectively. A difficult person is anyone who causes anyone else irritation, upset, stress or anxiety. There are three levels of difficult persons;First level - are difficult some of the times and it includes almost everybody; Second Level - when a person's behavior affects more than one person on a regular basis; Third level - includes persons who purposely hurt or harm others through their behavior. Such persons are rare but really test your skills when you come across them.(14) Difficult colleaguescan be dealt by sharpening the following skills: Separate person from problem. Practice to keep your focus on the problem you are discussing and not on the person. If you keep your focus on the person, even non issues will become issues. Agree on parameters with the person Agree with the person what are the issues that need to be addressed and resolved. Focus your conversation on logic and issues. Look for options that will be agreeable to both of you. Managing 360 degrees Successful leaders and managers manage in all three directions at the same time; downwards- their subordinates, upwards - their bosses, and horizontally - their peers. This is referred to as managing 360 degrees. The skills of managing team always receive attention in most training courses on leadership. The skills of managing up and across are very often neglected. These skills are equally, if not more, important to succeed.(15) To reach leadership position and become an effective leader one must acquire skills to manage 360 degrees. Walk the talk A leader is always under watch by his team and peers. Every step you take, every word you speak, your body language and behavior are under continuous observation. As a leader one is asking his team to have some values and skills. He has to demonstrate these in his day-to-day work and behavior and only then others will take him seriously. Conclusion The three domain model, based on leadership theories, gives a good insight into areas requiring attention in learning leadership skills.(16) All three domains [Figure 3] need attention at every level of career. However, as one moves up in hierarchy, the priority shifts from managing self to devote more time to managing teams and when at the top managing with an eye on what is changing in health and other sectors. In the first domain address skills for managing self(12) and in the second domain the skills of building and leading teams,(17) managing bosses and peers.(14) The third domain includes change management skills(18) and this concluding article covers leveraging your contacts to achieve your goals and other skills such as managing difficult people, concept of 360 degree leadership and need for the leader to walk the talk. Figure 3 Three domains leadership capacity development model Recent understanding of health determinants outside of health sector contribute much more to health and there is a need for public health professionals to convince their peers, administrators and politicians within the health sector to influence other ministries and departments to address these determinants to achieve sustainable improvement and inequities in health. The inequities in health are due to underlying causes such as poverty, lack of water and sanitation, livelihood etc which are essentially in sectors outside health. The health professionals while continuing to advocate for more resources to improve health care need to get other ministries, sectors and departments at all levels to take actions for improving population health. To do this they must acquire skills to identify and use ‘windows of opportunity’, advocacy, networking and negotiation.

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          Health Promotion: An Effective Tool for Global Health

          Health promotion is very relevant today. There is a global acceptance that health and social wellbeing are determined by many factors outside the health system which include socioeconomic conditions, patterns of consumption associated with food and communication, demographic patterns, learning environments, family patterns, the cultural and social fabric of societies; sociopolitical and economic changes, including commercialization and trade and global environmental change. In such a situation, health issues can be effectively addressed by adopting a holistic approach by empowering individuals and communities to take action for their health, fostering leadership for public health, promoting intersectoral action to build healthy public policies in all sectors and creating sustainable health systems. Although, not a new concept, health promotion received an impetus following Alma Ata declaration. Recently it has evolved through a series of international conferences, with the first conference in Canada producing the famous Ottawa charter. Efforts at promoting health encompassing actions at individual and community levels, health system strengthening and multi sectoral partnership can be directed at specific health conditions. It should also include settings-based approach to promote health in specific settings such as schools, hospitals, workplaces, residential areas etc. Health promotion needs to be built into all the policies and if utilized efficiently will lead to positive health outcomes.
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            From theory to action: applying social determinants of health to public health practice.

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              Building and Leading Teams

              Introduction The skills related to team building pertain to the second domain of the three domain model of leadership described in previous article.(1) The skills related to managing self, such as emotional competencies, time management and active listening are foundational for managing and leading teams.(2) In the hierarchy of leadership a competent and highly skilled individual is at the first level of leadership, in the second level of leadership s/he also becomes an effective team player while updating technical expertise and at the third level s/he becomes an effective team leader while retaining the skills of the first two levels.(3) The skills of team building play a pivotal role in achieving the goals of the organization. These skills are even more important in health sector both in clinical and public health settings. The most distinguishing characteristic of a team is collective vision towards the accomplishment of goals. The team is a symbiotic relationship complementing and supporting each other's skills, communicating openly and clearly with one another and holding themselves mutually accountable.(4) Its members respect and trust each other and strongly believe that every member brings unique skills and strengths to the team and the right competitive spirit to bring the best contribution. However, the structure of team differs depending upon its purpose, its task, its setting, the mix of professions and the formal relationship between health professionals in it.(5 6 7) The team based practice is well understood only when the distinction between team, team work, collaboration and collaborative practices is known. In developed countries the teamwork and collaboration in healthcare delivery has been discussed in government reports as a key strategy in health care renewal.(8 9 10 11) Team Building in Health Care Systems Team work has shown improvement in performance in many aspects of healthcare in primary health care and public health systems. The evidence suggests that quality of care, patient safety, shortage of manpower, and stress among health care professionals is managed better through an effective team work.(12 13) In the ‘Team Method’ in nursing care of indoor patients, all the staff members under the leadership of a professional nurse, are assigned to a group of patients, who assigns the tasks, supervises, instructs, guides and coaches them- the team. It is an excellent and most desirable method but requires good team building and supervision. It is generally preferred over ‘Case Method’ where a nurse is assigned to the complete nursing care of a number of patients, or the ‘Functional Method’ where nurses are assigned specific functions for all the patients in the ward. The teamwork can significantly reduce workloads, increase job satisfaction and retention, improve patient satisfaction and reduce morbidity. The review of health care effectiveness literature suggests that decision making largely accounts for improvement in patient care and organizational effectiveness and the diversity of clinical expertise involved in a team. Collaboration, conflict resolution, participation, and cohesion are most likely to influence staff satisfaction and perceived team effectiveness.(14 15) In recent days organizing primary care services for acute, chronic and preventive care is a major challenge.(16) To handle such situations successful teams and team work always matters to accomplish the task with collaborative efforts. Many studies have identified teamwork as an essential tool for high quality work and safe patient care.(17 18) The teams that work together are more effective and innovative. High quality health care is achieved if team motives are clearer. The participation level of the team members has greater emphasis on quality and support for innovation. Hospital research also shows working in team lowers level of stress.(15) The health care has changed enormously in past 20 years. This rapidity of change continues to accelerate and both clinicians and patients need to integrate new technologies into management of wellness and illness.(19) Thus the leaders in health sector need to look beyond health sector to address health determinants in other sectors to improve health. Teams are Dynamic Building effective team is necessary for creating an appropriate organizational environment.(20 21) Bruce Tuckman has described four main stages of team development: Forming, Storming, Norming, and Performing. Later a fifth stage of Adjourning/Transforming was added.(22) The forming is the initial phase of team building, members are uncertain about their roles, rules, norms, and expectations from them. The next step is, storming where members tend to get into competitiveness, defensiveness, jealousy, and conflict over roles and personalities; members may become critical of the leader and of each other. In norming members get to know each other, agree on the norms, working styles and systems to follow. In performing the teams works with positive and creative attitude to achieve the goals. Finally in adjourning, after completion of the team tasks, members bring a sense of closure and bonding between members. Most experts in team development agree that teams go through five different stages mentioned above but how fast a team moves through each stage will depend on the team members, their individual skills, the work they are expected to do, and the type of leadership available to the team. Allan Drexler and David Sibbet's(23)"Team Performance Model"illustrates team development as seven stages, four to create the team and three to describe increasing levels of sustained performance which are summarized below: Creating stages Orientation: Why I am here? Trust Building: Who are you? Goal and role definition: What are we doing? Commitment: How will we do it? Sustaining stages Planning: Who does what, where? Implementation: High performance stage Reassessment & renewal: Do we continue? Yes, why & how? The Creating stages of Drexler A and Sibbet E correspond to Forming, Storming and Norming stages of Tuckman B Model and Sustaining stage corresponds to Performing and Adjourning stages. A good team leader understands the dynamics of a team and takes it to performing stage(s) as soon as possible by actively engaging with the team members to ensure smooth transition through creating, forming, storming and norming stages. The proper transition through creating stages is important and has strong implications for team performance. The teams do not necessarily pass through the above mentioned stages and stay in the stage reached but keep moving back and forth. The various factors, such as, new member(s) join and current members leave, new tasks are assigned, the leadership changes etc keep the teams moving back and forth among various stages. The leader has to remember that storming stage is a necessary evil and s/he has to anticipate and closely observe the issues which may hinder progress towards achieving the goal and proactively address the issues fast before it assumes self defeating proportions. Behaviors that Promote and Hinder Teams Work Lencioni has described five dysfunctions of team, discussing why teams, even the best ones, often struggle.(24) The first dysfunction he describes is “absence of trust”. Without trust neither the team can be formed nor can they achieve results. The fear of conflict, lack of commitment, avoidance of accountability and inattention to the results were the other dysfunctions. In fear of conflict, the team members ignore controversial issues that may be critical to team success, waste time and energy in interpersonal risk management to keep harmony in the team. Lack of commitment and avoidance of accountability, creates ambiguity in the team about direction and priorities. The team misses deadlines and deliverables, places an undue burden on the team leader as the sole source of discipline. Inattention to results occurs when members of the team seek individual recognition and goals at the expense of the collective goals and often work towards ‘saving own skin’ and pass on the blame. Ego and status can lead to team members focusing on their individual accomplishments instead of the common purpose. Table 1 below summarizes the qualities and obstacles of effective team work. Table 1 Facilitative and obstructive behaviors for team work Motivating Team Members Motivation is accomplishing things through the efforts of others. It is important for the team leader to keep his team motivated to achieve the desired results. Job performance = ability × motivation × organizational support. Only motivated team members can produce quality work. What motivates people may include money, power, attractive position, enhanced self respect on accomplishing a task etc. A motivated team member is able to do more and adds quality to whatever he does. Motivating employees is not a one time or a periodic but is an ongoing activity both during bad and good time an individual, team or an organization passes through. It requires more attention when an individual, team or an organization is passing through a turbulent phase. According to Maslow a person works to satisfy his needs which he described as a hierarchy. The first need, Physiological Needs, was the basic need essential for survival like salary, working conditions etc. Once the first need was met one worked for the next need i.e. Safety/ Security like job security, insurance or son preference in India followed by Social Needs like connecting with people and being accepted. Once these lower order needs were achieved one worked for higher order needs like Self Esteem, wherein one looked for self -respect, appreciation etc. The last stage, Self-Actualization, was achieved when one was self -driven and worked for growth and self-fulfillment. Thinkers came up with other theories which were similar but looked at motivating people from different angles. Herzberg gave a slightly different perspective in his Two Factor Theory. Not disagreeing with Maslow, he differed with the traditional view that, while working, the opposite of Satisfaction was Dissatisfaction. So there was either Dissatisfaction or No Dissatisfaction in work. Similarly the employees found Satisfaction or No Satisfaction in their work. Job Dissatisfaction could be reduced by Hygiene Factors like salary, facilities like housing, health insurance, working conditions in office. Poor hygiene factors would make the person unhappy and irritated but their absence would not make him enthusiastic to work, which would be determined by the work itself. Determinants of Job Satisfaction were Motivators: The work itself, responsibility, advancement, recognition etc. If they were absent there would be no satisfaction in the job, while he may not be dissatisfied if the hygiene factors were present. Motivators would increase job satisfaction while the hygiene factors would reduce job dissatisfaction. Money as a reward would be a motivator otherwise a hygiene factor. The leader of team should focus on Job enrichment (the work itself) as a job satisfaction strategy when money and hygiene factors cannot be increased or no longer motivate a staff member. Job Enrichment In most situations it is not possible to promote or financially reward good work for motivating team members. In such situations job enrichment is a good practice to keep a staff member motivated and acquire new skills. The job must be designed to provide opportunities for achievement, recognition, responsibility, advancement growth. Designing jobs that include a greater variety of work content requires: A higher level of knowledge and skill. Give employees more autonomy and responsibility in terms of planning, directing, and controlling their own performance. Provide an opportunity for personal growth and meaningful ful work experience. Get due credit for the success achieved. Five core dimensions that enrich jobs Benefits for job enrichment for health care organisations Job enrichment benefits both the team members and the organisation. It benefits a team member by giving more job satisfaction, greater responsibility and authority, the opportunity to experience more growth and development, a greater sense of achievement, more job autonomy and a greater diversity of job experiences and more practice at taking decisions. It benefits the organization by higher level of job performance, imoroved quality of patient care and services, improvement in quality of decisions, increased employee's loyalty and commitment to organisation, lesser absenteeism and lower turn over rate. Mentoring and Coaching Mentoring and coaching skills are a must for leaders and managers. In formal education of health care professionals, mentoring is considered as a fundamental tool for helping people achieve required competencies. Formal and informal mentoring has been increasingly encouraged as a way of supporting people's continuing professional development.(25) Mentoring is primarily the identification and nurturing of potential for the whole person. It can be a long-term relationship, where the goals may change but are always set by the learner. The learner owns both the goals and the process. Feedback comes from the mentees – the mentor helps them develop insight and understanding through reflections, that is, becoming more aware of their own experiences and areas of improvement.(26) However, coaching relates to performance improvement (often short-term) in a specific skills area. The goals are typically set with or at the suggestion of the coach. While the learner has primary ownership of the goal, the coach has primary ownership of the process. In most cases, coaching involves direct extrinsic feedback (i.e. the coach reports to the coachee what he or she has observed).(27) The mentor or coach may be a supervisor or a leader. Leaders prioritize time for the ongoing coaching that is an important element of team success.(21) 70% of the leading employers use coaching and mentoring in their workplace to create higher organizational performance. It increases creativity (69%), learning and knowledge management (63%) and motivates people (57%).The study conducted by the Chartered Institute of Personnel and Development indicates that 93% of all the respondents believed coaching and mentoring is a key mechanism for transferring training skills into the workplace.(28) Figure 1 below gives the stages in the coaching and mentoring relationship. Figure 1 Stages in the coach-mentoring relationship(25) Conflict Resolution It is important for team leader to encourage team members to bring in different opinions to enrich the work of the team. This needs to be accepted by team members without bringing their ego into play. The team members should look at these as differences on issues rather with other team members. The role of the leader is to ensure that these differences are dealt with in a healthy manner and do not lead to conflict. Conflicts are disagreements that lead to tension within, and between people. Often people are confused between conflict and disagreement. Conflict is a more serious form of disagreement. When two people are having disagreement their relation is intact and in conflict, the relation often turns sour and dialogue ends.(29) Many factors in health care system can contribute to the escalation of conflict. It starts from the disagreement and once the conflict escalates the focus shifts from the issues to the person's faults leading to expansion of problem with breakdown of dialogue. The escalation of conflict is enemy images, resulting in violence, dehumanization process leading to open hostility and polarization where co-existence is no longer possible. A conflict brings down the productivity of the team and vitiates the work environment preventing members to put in their best.(29) An important skill for team leader to have and impart to team members is negotiation skill. This will be dealt with in a subsequent article. At an organizational level, the process of conflict resolution is an opportunity for growth and change in a work environment. Conflict resolution is important for the bottom line on an organizational level as well as for personal achievement to see change in overall success.(30) Proper conflict management contributes to higher effectiveness, trust, and openness and results in successful conflict resolution.(31) In organizations where conflict is not viewed positively or as an opportunity for improvement, see conflict as unproductive, unpleasant, and a waste of time and energy. If conflict is not controlled early, it can have damaging effects in the workplace, stifling the growth of departments and deflating employee morale.(32) Conclusion Skills of team building are essential for every manager and leader. The teams are dynamic and are created for a purpose. Only a good team player can become a good team leader. It is important for the team leader to take them through team creation stages and move to productive stage. In the productive stage team members complement each other's skills and efforts to achieve common goals. In the process they trust and respect each other's opinion, even when the views differ. Team leader and members acknowledge each other's contribution and inputs. The team leader steps in early to resolve conflict when it arises. S/he keeps them motivated through recognition and coaches and mentors them when required. Job enrichment is one important way of acquiring new skills and keeping team members motivated.

                Author and article information

                Indian J Community Med
                Indian J Community Med
                Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine
                Medknow Publications & Media Pvt Ltd (India )
                Jul-Sep 2015
                : 40
                : 3
                : 158-162
                Executive Director, Healthcare Financing, National Health Systems Resource Centre, National Health Mission, Ministry of Health and Family Welfare, Government of India, NIHFW Campus, New Delhi, India
                [1 ]Department of Pathology, Faculty of Dentistry, Jamia Millia Islamia, Delhi, India
                [2 ]Department of Community Health Administration, National Institute of Health and Family Welfare, New Delhi, India
                [3 ]Senior Consultant, Healthcare Financing, National Health Systems Resource Centre, National Health Mission, Ministry of Health and Family Welfare, Government of India, NIHFW Campus, New Delhi, India
                Author notes
                Address for correspondence: Dr. Sanjiv Kumar, National Health Systems Resource Centre, National Health Mission, Ministry of Health and Family Welfare, Government of India, NIHFW Campus, Baba Gangnath Marg, Munirka, New Delhi - 110 067, India. E-mail: drsanjivkumardixit@ 123456gmail.com
                Copyright: © Indian Journal of Community Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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