Leadership is expressed in daily, persistent behavior that influences people to execute and accomplish the mission of the organization. The behavior of an individual leader is the most important predictor of a high level of organizational performance. These days, the question on the minds of all health care leaders is: "How do I lead my organization through the constant changes driven by the market and health care reform?"

Influential leaders succeed where other leaders fail because they perform at a higher level, are more productive and achieve better results, even when faced with similar circumstances and given the same resources. Their effectiveness derives from what is commonly referred to as tactical capacity — behaviors that enable them to become role models, guide operational improvements, consistently execute strategy and sustain performance.

Essential Leadership Skills

Seven skills comprise this tactical capacity:

  1. attentiveness
  2. alertness
  3. appreciation
  4. thoughtfulness
  5. a learner's attitude
  6. humility
  7. selflessness

Developing Attentiveness

Influential leaders give their key staff members their undivided attention every day. Whether forming leader huddles, using the old Hewlett-Packard "leading by wandering around" approach, or rounding for outcomes, they are available and genuinely attentive to the needs of the people doing the work of the organization.

Do not convey the message "Here I am. What do you want to tell me?" — or any other impatient, negative message. Nothing will communicate more effectively the feeling that meeting with your people is drudgery to you. If you isolate yourself as a leader, any leader at any level, you do so at your own risk and to the peril of your organization's mission and performance.

Developing Alertness

Influential leaders have a highly developed empathic sense. They are able to detect when another person is in distress and respond accordingly. More attitudes are communicated through facial expressions than most people realize. The forehead, the eyes and the mouth will, many times, show that the inner emotional state of people is not in agreement with their words.

Be especially watchful of a person's eyes and mouth when you are talking about controversial subjects. Be willing to change your behavior or the words you are using if you see a negative reaction — record in the library of your mind which words and actions cause a negative reaction and make a note to avoid them in the future.

Developing Appreciation

Influential leaders constantly are looking to praise people for their good qualities — daily! Leaders should spend a great deal of time catching people doing the right things and acknowledging them for it. It's hard for leaders to look for things to praise and then express appreciation to their followers; when they see something positive, they tend to take the good for granted and fail to express their appreciation for the great work.

Everyone enjoys receiving an expression of appreciation. Expressing appreciation is good for both the giver and the receiver. Appreciation fosters a positive attitude and work ethic. Learn to encourage others, express your appreciation for their good work and watch them improve performance.

Developing Thoughtfulness

Any successful leader knows that effective communication is a critical element of execution and peak performance. Do you make independent decisions or do you include your team members as part of the decision-making process? Are you open to suggestions? Do you express thoughtfulness in your daily relationships with your team members?

Autocratic, independent behavior on the part of a leader breeds contempt and even open rebellion in the workplace. Thoughtfulness means waiting to make key decisions until you get team member feedback on the likely consequences of a decision. If your current style is to act independently, do not be surprised if it takes some time to coax your team members to provide their input and to believe that you are sincere in seeking their opinions. Thoughtfulness builds a positive emotional connection with people.

Developing a Learner's Attitude

Success in every part of life is related to an ability to connect with others. Your success is directly related to your willingness to learn, to change, to adapt and to grow. Relationships by their nature require constant tending.

When leaders share meaningful learning experiences with their employees, employees become more engaged in their work and more supportive of their leader. Employees try harder to meet or exceed performance expectations to show their appreciation that the leader cared enough to find out what they need and to recognize their hard work and contributions.

Undergoing a continuous learning process entails change; one cannot learn and still be the same person, team or organization. There is a constant evolution in the way we think and act, brought about by new understanding, new knowledge and new skills. One of the worst sentences that you or any other person can say is: "I already know that" — because this attitude can destroy any chances of continuous learning. And when there is no learning, there is no growth.

Finally, develop the ability to learn from both success and failure. John Maxwell wrote about "failing forward;" if you can increase your number of failures, you will increase your number of successes. Maxwell encourages people to learn from their failures to prevent repeating the same mistakes. How many times have you asked the question, "When are they going to get it?"

Developing Humility

In their book The Laws of Lifetime Growth, Dan Sullivan and Catherine Nomura write about the connection between humility and leadership influence:

"Only a small percentage of people are continually successful over the long run. These outstanding few recognize that every success comes through the assistance of many other people — and they are continually grateful for this support. Conversely, many people whose success stops at some point are in that position because they have cut themselves off from everyone who has helped them. They view themselves as the sole source of their achievements. As they become more self-centered and isolated, they lose their creativity and ability to succeed." 
Humility is a key factor of leadership character that Good to Great author Jim Collins identified in what he calls Level 5 leadership — that combination of complex and sometimes contradictory traits of humility and internal drive at the top of his hierarchy of management personal attributes.

As a leader, can you give up what you believe is your right to find fault with others? Can you accept personal accountability and responsibility for the stewardship obligation you have accepted as a leader? Can you be open to receiving candid and honest feedback about your own behavior and its impact on those you lead? Can you welcome others' help in learning about your own habits to improve the effectiveness of your influence?

There is a lot written about lack of employee engagement, motivation and performance. Is it possible that this fault-finding in employee performance is a reflection of ineffective leadership? Unless you develop leadership with humility, you will not even be willing to ask the question.

Developing Selflessness

In their book High Altitude Leadership, Chris Warner and Don Schmincke discuss the debilitating toll selfishness takes on companies. They call the destructive and unproductive condition of selfishness "dangerous, unproductive, dysfunctional" behavior, or DUD behavior. They provide excellent examples of how DUD behavior is manifest by individuals and organizations.

Here are three simple rules to overcome selfishness:

Choose to think of others first. Everyone has to make tough decisions at times, and those decisions inevitably will affect others. However, if you pause for a moment and think of how your actions will have an effect on other people, you can build positive relationships that drive performance.

Practice integrity. By living with integrity you will naturally find yourself looking out for the best interests of others. Your values and beliefs will naturally move toward altruistic behavior and away from selfishness.

Develop trust. Trust remains the relationship imperative. The very act of focusing on building trust will lead you to behaviors that build trust with others. Take the time to develop unselfish behaviors and you will create a culture of trust.

Leadership Responsibility

Influential leaders recognize the importance of self-awareness, collaboration and highly effective relationships. They spend time focusing their efforts in key areas that will build connections with the people they lead to drive performance. They focus these efforts on the fundamental skill set of tactical capacity.

When you have a meaningful relationship with another person, you work more effectively together. You have a common goal and a consistent purpose. Your efforts are channeled toward the same common outcome, and you improve performance in the organization to peak levels.

Michael Frisina, Ph.D.,is the CEO of The Frisina Group, LLC, based in Elgin, S.C. He is also the founder of The Center for Influential Leadership; a former faculty member of The United States Military Academy at West Point; and a retired officer from The United States Army Medical Department. He is the author of Influential Leadership, a new book from AHA Press, and a member of Speakers Express.