malaysian nurses governance and leadership training€¦ · malaysia leadership and governance...

MALAYSIAN NURSES GOVERNANCE AND LEADERSHIP TRAINING

Kuala Lumpur Malaysia 1-2 August 2009

conducted by the Malaysian Nurses Association

in collaboration with the Commonwealth Nurses Federation

FUNDED BY THE COMMONWEALTH FOUNDATION

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____________________________________Commonwealth Nurses Federation

Malaysia Leadership and Governance Training 2009

Malaysia1-2 August 2009

Leadership and Governance

OBJECTIVES

• To equip young nurse leaders with the knowledge and skill to become effective and efficient

nursing leaders of the future

• To develop skills for young nurse leaders in planning strategically to achieve goals

• To explore the principles and application of being an effective advocate and to develop skills in lobbying

• To develop and understanding of the principles and application of good governance

• To develop strategies for engaging with government and in influencing nursing and health policy at government level

• To develop skills in engaging with the media and in working with communities to achieve goals

PARTICIPANTS

Siti Rahmah binti Abdullah Mek bt Jusoh Latiffah binti Ishak Letchmi Devi Anida Elias Vanessa Vincent Paul Norhaiti Basir Selmi Binti Hamdan Wong Mei Tieng Dora Anak Nyangga Noor Dayanawali Ab Majid Hee Kim Lan Farrah Ong bt Abdullah N Ampihavathi Leong Foong Khuan Fu Choon Kee Saniah Said Aieshah Zainudin Salwismawati Badrin Ruhamah Naam Masnah Abd Moen @ Muin Puah Hooi Meng Pani Malar Sinnathamby Radziah bt Idris Chau Suet Kheng Sek Shoa Chioa Intan Salwah Bakri Zarinah Ahmad Aisyahton Suhaimi Mahinder Kaur Pritam Singh Salwa Krishnan Abdullah Ropani bt Taib

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INTRODUCTION Participants introduced themselves to each other and were introduced to the purpose and objectives of the Commonwealth Nurses Federation. The opening exercise gave participants an opportunity to share their immediate concerns and aspirations about the governance and leadership training.

SESSION 1: Good governance

DEFINITION OF GOVERNANCE

Governance is the process of governing - whether that be a country, a business, or an organisation. Governance refers to the mechanisms in place to ensure: the mission of an organisation is fulfilled; legal compliance; management of conflict of interest; and prevention of fraud and other improper or unlawful behaviour. It also encompasses the organisation’s structures, culture, policies and processes and accountability mechanisms; the way business is conducted; decisions are made; and how stakeholder relationships are managed.

A Coalition of National Nursing Organisations (CoNNO) in Australia in 2006 undertook a project to identify the principles of good governance and develop standards of good governance. The section of the training on governance is based on that work (Coalition of National Nursing Organisations (Australia). 2006. Governance standards for nursing and midwifery organizations: toolkit for organisations. http://www.conno.org.au/pdf/gov_standards_tool_kit.pdf).

http://www.conno.org.au/pdf/gov_standards_tool_kit.pdf�

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PRINCIPLES OF GOOD GOVERNANCE

• Accountability • Transparency • Integrity • Legality • Leadership • Stewardship • Efficiency • Social responsibility



* Accountability√ √ √ √ √ * Just/Consistent√* Transparency√ √ √ √ * Integrity/Trustworthy√ √* Commitment √ √ √ √ * Competent√ √ √ √* Legality√ √ * Advocacy√* Leadership√ * Vision√ √* Stewardship * Communication√ √ √* Efficiency * Innovative/Creative√ √* Social responsibility * Responsibility√

* Identity√* Respect/Empathy√* Loyalty√

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STANDARDS OF GOOD GOVERNANCE



Standard 1Being clear about the organisation’s purpose and outcomes to the membership, stakeholders and wider community



Standard 2Performing effectively and demonstrating accountability through clearly defined functions and roles



Standard 3Promoting values for the whole organisation and demonstrating the principles of sound governance



Standard 4Taking lawful, informed, transparent decisions and managing risk



Standard 5Developing the capacity and capability of the board or governing body to be effective



Standard 6Engaging the membership, stakeholders and wider community and making accountability real

Reference: Coalition of National Nursing Organisations (Australia). 2006. Governance standards for nursing and midwifery organizations: toolkit for organisations. http://www.conno.org.au/pdf/gov_standards_tool_kit.pdf


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IMPLEMENTING GOOD GOVERNANCE PROCESSES

____________________________________Commonwealth Nurses FederationMalaysia Leadership and Governance Training 2009

GOOD GOVERNANCESusie Kong, President

Commonwealth Nurses Federation

Leadership and GovernanceMalaysia 1-2 August 2009

WHAT IS GOVERNANCE ?

Governance is the process of governing - a country, a business or an organisation.

Governance is defined as an internal system covering policies, processes and people, which serves the needs of shareholders or owners by directing and controlling management activities with objectivity, accountability and integrity.

Key elements of good governance include honesty, trust, integrity, openness, performance orientation, responsibility, mutual respect and commitment to the organisation.

WHAT IS A GOVERNING BOARD?

A governing Board plays a key role in governance. It is their responsibility to endorse the organisation’s strategy, develop directional policy, appoint senior executive, and ensure accountability of the organisation to its owners and authorities.

WHO ARE THE OWNERS ?

• In the business sector, the owners are the shareholders of the corporation.

• In a professional association, the members are the owners.

GOVERNING BOARDOF NON-PROFIT ORGANISATION

In many non-profit organisations, the governingBoards are volunteer Boards and Board members areeither elected or appointed according to theorganisation’s constitution.

The Board is the highest policy and decision-makingbody and has the responsibility of ensuring that theorganisation is governed and managed effectively andefficiently.For greater accountability, it is better to separate theroles and functions of Board and staff.

BOARD-EXECUTIVE LINKAGE

Board and Executive constitute a leadership team. Clear differentiation in their roles and responsibilities enable them to fulfil and excel in them, mutually support each other, and influence each other toward greater integrity and capability for leadership.

KEY AREAS OF BOARD’S RESPONSIBILITY

• To ensure compliance with all applicable laws and regulations.

• To establish the organization’s vision, mission and directions.

• To ensure the financial health of the organisation.

• To ensure the organisation has adequate and appropriate human resources.

• To ensure effective community relations.

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ROLE OF THE BOARD

The Board as a body, speaks for the owners. The role of the Board is to fulfil the governance responsibilities. In taking responsibility for its own performance, the Board acts as a group of peers, no one has authority over anyone else.

The Board should accept responsibility for financial governance, by setting policy and comparing performance.

BOARD SPEAKS WITH ONE VOICE

The Board speaks as ‘one voice’. ‘One voice’ does not require unanimous votes but it does require all Board members to respect the decision that has been made.

No Board member has the authority to speak for the Board unless specifically authorised.

Board’s decisions can only be changed by the Board, never by Board members.

ROLE OF THE CHAIRPERSON

The President, according to the Constitution is the Chairperson of the Board.

The Board grants the Chair authority to make rulings that keep the Board on track.

The Chair’s job to ensure that the Board gets the work done, as described in the governance process.

ROLE and RESPONSIBILITIES OF BOARD MEMBERS

Good governance requires Board members whocan think conceptually and with a long termperspective, and abide by group decisions. Thisrequires Board member’s expertise relevant togovernance and not management.

As the Board takes responsibility as a group,attendance at Board meetings is required ofBoard Members.

Once a Board member has made to commitmentto serve on the Board, the member has a duty tofulfil that responsibility.

ROLE and RESPONSIBILITIES OF BOARD MEMBERS

Failure to attend three regularly scheduled meetings consecutively generally constitutes that member’s resignation from the Board.

Board member must prepare for meetings and participate productively in discussions, each contributing their knowledge and skills to Board’s effort to fulfil its responsibilities.

Board members are also expected to participate and support in events or functions organised by the organisation.

BOARD MEETINGS

Board meetings provide an opportunity for Board members to learn together, to contemplate and deliberate together, and to decide together.

The Board is the body that makes decisions, therefore, Board meetings should focus more on the future than the present.

The Board should set agendas for Board meetings and items for discussion should include strategies for achieving the vision and mission of the organisation.

ROLE OF CHIEF EXECUTIVE OFFICER

The Board has total authority over the organisation and total accountability for the organisation. But the Board is almost always forced to rely on others to carry out the work.

The use of a Chief Executive Officer (CEO) or Executive Director (ED) position considerably simplifies the work of the Board.

With the CEO, the Board can express its expectations for the organisation leaving the CEO to work out exactly how the work is organised to meet the Boards’ expectations


The roles of the Chair and CEO should not overlap because the Chair’s job is to see that the Board gets the job done and the CEO’s job is to see that the staff gets the job done.

The CEO is accountable to the Board for the staff and any interference by the Board, even when well-intended, will undermine the Board’s ability to hold the CEO accountable.

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Although the Board uses the CEO to fulfil its responsibilities, the Board is still accountable for the organisation and therefore has total authority over it, including over the CEO.

The Board creates the CEO position and is accountable for what the CEO’s job is. The CEO however is not accountable for what the Board does.

CONCLUSION

The Board acts as trustee on behalf of theowners.

The effectiveness of an organisationdepends on both the people and the way itis governed.

Transforming today’s reality intotomorrow’s possibility requires acommitment to good governance practices.

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GOOD GOVERNANCE EVALUATION EXERCISE

Assessing your organisations governance: a self assessment tool national nursing organisations | governance standards for nursing and midwifery organisations - toolkit Understanding the importance of governance This section can assist in assessing how individuals or groups rate the importance of key governance themes and may help identify areas for improvement. Please indicate in the following table how important you feel the following aspects of governance are for the provision of sound governance. Essential Preferable Sometimes

necessary Not necessary

1. Focus on the organisation's purpose?

2. Consider outcomes for the membership and wider community?

3. Perform effectively in clearly defined functions and roles?

4. Promote values for the whole organisation?

5. Demonstrate the values of sound governance through behaviour?

6. Take informed transparent decisions?

7. Manage risk?

8. Develop the capacity and capability of the board/governing body to be effective?

9. Engage the membership?

10. Be accountable to stakeholders?

Reference: Coalition of National Nursing Organisations (Australia). 2006. Governance standards for nursing and midwifery organizations: toolkit for organisations. http://www.conno.org.au/pdf/gov_standards_tool_kit.pdf


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SESSION 2: Strategic Planning Participants were given different scenarios which they used to think and plan strategically using the following framework: ∗ Having a clear vision ∗ Setting realistic goals ∗ Determining effective strategies ∗ Implementing strategies ∗ Checking progress ∗ Evaluating outcomes SCENARIO 1 You are a group of nurse middle managers. You understand that the nurses at your hospital are carrying unacceptable workloads, which is resulting in decreased patient care, decreased job satisfaction and increased sick leave and stress leave. You want to prepare a proposal to put to your hospital management to establish nurse to patient ratios.

SCENARIO 2 You are a group of nurse middle managers. You know that the future for nursing education is in the training for all registered nurses being established at degree level. You want to prepare a proposal for your government for all nursing education to be at degree level.



Leadership in any organisation includes defining where the organisation is going ... setting the direction ... having vision.

Any issue can be approached using strategic thinking: what are we trying to achieve? What do we need to do to get there? How will we make it happen? How will we monitor progress?



Strategic THINKING is a way of being

Strategic PLANNING is a way of doing

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SCENARIO 3 You are a group of nurse middle managers. You understand that many of the nurses at your hospital are considering migrating to other countries. You are aware of the Commonwealth Code of Practice for the International Migration of Health Workers. You want to prepare a proposal to your government and your health service that they publicly support and promote the Commonwealth Code of Practice.

SCENARIO 4 You are a group of nurse middle managers. You understand there is a shortage of nurses and if you want to retain nurses at your hospital you need to make the working environment attractive to them. You have researched the ‘magnet hospital’ concept and want to make application for your hospital to have ‘magnet’ status. (The term ‘magnet hospitals’, is often used to refer to facilities that can attract and retain a staff of well qualified nurses and consistently provide quality care. Nurses in magnet hospital environments have lower burnout rates, higher job satisfaction and better patient outcomes. Magnet hospital criteria that are applicable to all work environments range from the general (eg a reputation for quality care and being a good place to work) to the specific (eg retention and turnover rates, adequate staff, flexible schedules, strong leadership and adequate salaries).

SCENARIO 5 You are a group of nurse middle managers. You know that your association, the Malaysian Nurses Association, is a member of the Commonwealth Nurses Federation. You want to promote Commonwealth Day to nurses across Malaysia by preparing a proposal to put to government, employers and the MNA to conduct an activity for nurses across Malaysia to commemorate Commonwealth Day. (The second Monday in March is Commonwealth Day. Its purpose is to promote understanding about global issues, international co-operation and the work of the modern Commonwealth. The Commonwealth is a voluntary association of 53 independent member countries. The Commonwealth is often called a family of nations and peoples. Its special strength lies in the combination of the diversity of its members and their shared inheritance in language, culture and the rule of law. In particular, the Commonwealth: • promotes democracy and good governance, sustainable economic and social development, respect for human

rights and the rule of law, gender equality and protection of the environment, • promotes partnership and co-operation among its members, • promotes understanding and tolerance among its citizens, and • reduces prejudice, ignorance, disease and poverty)

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SELF DEVELOPMENT EXERCISES

Being an effective leader means knowing your own strengths, weaknesses, views, opinions and prejudices. Self development exercises form an integral part of the governance and leadership training. Participants undertook a number of self development exercises to start to learn about themselves. The self development exercises for Sessions 1 and 2 related to identifying stress and burnout.

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EVALUATION All sessions were evaluated for how useful or enjoyable the session was to the participants, using a six point Likert scale with ‘1’ being the least useful or enjoyable and ‘6’ being the most useful or enjoyable. If participants enjoy a session it is more likely they will retain the knowledge gained.

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Session 1: Principles of good governance

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Standards of good governance

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Self development exercise

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Implementing good governance processes

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Good governance evaluation exercise

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Setting realistic goals

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Determining effective strategies

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Implementing stratregies

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Self development exercise

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Checking progress

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Evaluating outcomes

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Comments ∗ Excellent. Extraordinary method of conducting the course. Really leadership has taken place. ∗ Please conduct more courses in such a manner each year for our future nurse leaders. Thank you. ∗ I like the way the course has been conducted. Keep it up and thank you. ∗ Very useful and shall be applied. ∗ I would recommend this training to my colleagues so that we can nurture more future leaders in

nursing. ∗ Thank you to the Malaysian Nurses Association for organising the training. ∗ Thank you. It is great training.

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