peers in a range of situations, includ-
ing cross-functional teams, as illus-
trated by the OR scheduling example.
With the greater generational and cul-
tural diversity in today’s workforce,
successful managers understand that
the old command-and-control meth-
ods are less effective than using a
broad range of influence tactics with
subordinates. Successfully influenc-
ing OR nurses to be flexible and
helpful when scheduling changes
occur now goes beyond the director
of perioperative services simply
telling them where and when to per-
form their work. Being able to influ-
ence stakeholders outside one’s
organization has also become a
strategic advantage for leaders, who
can then better monitor environmen-
tal trends and help build their own
and the organization’s reputation.
MEASURING OUTCOMES
How does one measure the effective-
ness of using particular influence tac-
tics? A common method is to assess
the outcome, of which there are three
potential types. The first type, com-
mitment, is accomplished by persuad-
ing another party, through internaliza-
tion of a positive attitude, to perform
a desired action. This is usually
accomplished by using tactics such as
personal persuasion or consultation.
The second type, compliance, is task
performance with the appearance of
conformity. Although there are
instances where such compliance is
sufficient, the underlying lack of
agreement can actually cause the
third type, resistance.
BEST PRACTICES
What are some of the best practices
for developing a strategic perspective
and method for deciding which tac-
tics to use in any given situation?
First and foremost, good leadership
practice requires that influence
attempts be used in an ethical manner
and only for legitimate organizational
LIA VOLUME 26, NUMBER 1 MARCH/APRIL 2006
purposes. This is important to a
leader’s strategic objective of build-
ing a personal reputation for effec-
tively accomplishing goals through
others.
The second strategic objective is
to build a web of interrelationships
that will aid in accomplishing current
and long-term objectives. Leaders
begin the forging of this network by
determining the appropriate stake-
holders, potential allies, mentors,
supporters, and competitors. Learning
their goals, priorities, commitments,
and other motivations is important to
satisfying their needs and gaining
their goodwill.
A three-step process is helpful
when deciding on the appropriate
influence tactics to use in a particular
situation:
Determine which individuals
and groups are needed for support,
and consider why they might back a
request.
Assess sources of potential
resistance, whether overt or covert,
along with the reasons why they
would resist.
Equipped with the knowledge
gained from the first two steps, con-
sider which tactics have worked with
each target in the past.
Part of the choice of appropriate
influence tactics will depend on the
particular context, the nature of the
tactics, and the potential benefits and
costs that stakeholders perceive for
themselves. Thus, determining the
strategy includes assessing and com-
municating each party’s benefits and
costs in the short term and the
impacts of the strategy on long-term
relationships.
A COMPLEX TASK
Scientist and physician leaders need
to apply a full range of influence tac-
tics in appropriate contexts to
accomplish critical organizational
objectives. The multiplicity of stake-
6
attracting the types of cases that yield
substantial hospital fees.
When disruptions and challenges
occur, the three leaders use a range of
influence tactics, such as moral suasion
(in regard to the purposes of competing
requests), personal appeals to what are
often strong egos, sensitivity to hierar-
chies between doctors and nurses, and
other combinations of tactics depend-
ing on the needs of the individuals
involved. Skillful influencing results in
an optimal schedule—successfully
moving nurses to appropriate ORs and
having surgeons and anesthesiologists
arrive promptly and complete their
cases in a reasonable time.
FOUR DIRECTIONS
Influence may be exercised in four
directions in power structures:
upward, laterally, downward, and out-
ward. Upward influence includes both
direct managers and others of higher
status in the organization, who may
be in a matrix relationship or could
become potential mentors. Physician
and scientist executives who recog-
nize the importance of moving
beyond a purely fact-based perspec-
tive in order to accomplish organiza-
tional goals may more easily request
and accept political and interpersonal
advice from those superiors.
An increasingly important aspect
of leadership involves influencing
A three-step process is
helpful when deciding
on the appropriate influ-
ence tactics to use in a
particular situation.

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