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Leadership theories and their applicability in healthcare systems

Discuss about the Leadership for Healthcare Management Forum.

Leadership is referred as concept which defines the behavior of person while directing a group towards a shared goal. The most important feature of leadership involves influencing group activities and dealing with the change. The biggest issue faced by the healthcare professionals in context of leadership is that maximum theories related to the leadership are developed from business point of view and not from the health care point of view. In other words, theories developed in business context are also used for the healthcare purpose. Published researches in this context provide very few evidences related to initiatives in leadership that are allied with the improvements occurred in the patient care or results related to the organization at the time when they are applied in healthcare setting (Garman, Brinkmeyer, Gentry, Butler, Fine, 2010).

It must be noted that leadership theory is dynamic in nature and changed with the time. The early great man theory stated that different individuals have different factors that make them good leaders. Different behavioral theories were developed between the year 1940 and 1980 which also describe common  leadership styles such as authoritarian, democratic and laissez-fair. Situational and contingency theories were also developed between the years 1950-1980, and these theories documented the significance of seeing the needs of the employees, the task to be performed, and the situation or environment (Sawai, 2013).

Interactional leadership theories mainly focus on influence within the particular organizational environment, and the interactive leadership skills of the leader with the follower.  This theory is based on the organizational behavior studies which further stated if people have supportive leaders who support them at personal level then such peoples are happier.

Healthcare bodies include numbers of professional groups, departments, and specialties with complex and nonlinear connections between them. It must be noted that complexity of these systems is generally unequaled because of the constraints related to the different disease areas, multidirectional goals, and multidisciplinary staff. Within these health care systems there are number of groups which belong from different cultures might provide support to each other or be in fight with each other. Leadership needs to be capitalizing in these health care systems in efficient manner for the purpose of ensuring efficient utilization of resources while designing the process of management and for encouraging the personnel to work towards the common objectives. There are different leadership approaches which can be used by the healthcare systems for the purpose of improving the management in this highly complex environment (Garman, Brinkmeyer, Gentry, Butler, Fine, 2010).

Leadership concepts

This report discusses the leadership and management within the healthcare sector, and for this purpose we define important concepts from the leadership and management field which also includes followership. Lastly, paper is concluded with brief conclusion.

Nursing is considered as noble profession which requires selfless leadership, and the duties of nursing leader include ensuring the highest regulations and standards of patient care by managing the human and financial resources in effective and efficient manner. The main concept of nursing leadership includes commitment, vision, and direction. Good leaders conduct such actions which inspire their followers in positive manner.

It must be noted that the prime objective of leaders in health care systems are ensuring such sustaining cultures that ensure high quality and compassionate care for patients. As per the results of one research, for the purpose of achieving this target five key cultural elements must be present and these elements include:

  • Leaders must inspire their visions which are operationalized at each and every level.
  • Leaders must provide clear objectives to all the team members, departments, and individual staff.
  • Must ensure supportive environment and also high level of staff engagement.
  • Leaders must ensure inclusion of learning, innovation and quality improvement in the practice of all staff members.
  • Effective working of the team (West, Lyubovnikova, Eckert & Denis, 2014).

For the purpose of ensuring high quality of care, there must be direction, alignment and commitment to be shared. Leader also ensure holistic view of care which also includes commitment for the purpose of improving linkages with other providers in the system and also for achieving the main objectives of the system such as continuity of care (Woods, Baker, Charles, Dawson, Jerzembek, Martin, McCarthy, McKee, Minion, Ozieranski, Willars, Wilkie, and West, 2014).

Above stated research further stated that leaders related to the best performing health care systems prioritized a vision and also develop strategic framework for the purpose of focusing on high quality and compassionate care. In these healthcare systems, different leaders clarify that high quality compassionate care was the main and priority purpose of any health systems. Various evidences are present which stated that such arrangement has an important influence for the purpose of reducing the effects of faultiness, and this is defined as difference occurred in group and status that interfere with the effective collaboration. This is a very common issue in the health care systems (Bezrukova, Thatcher, Jehn, Spell, 2012).

Another important target for health care leaders is job satisfaction of their employees. When staff of the healthcare system of the organization reported that they are completely satisfied with their immediate supervisors and patients reported that they are treated with care, respect, and compassion then such supervisor is considered as effective leader.

Emotional and Social intelligence (ESI) is the approach with correlates with the ability of the person in self-awareness, self-management, social awareness and relationship management. These skills facilitate the understanding and managing of social importance. If leaders in the health care system adopt this approach then they get separate benefit related to their positions. This approach also helps the leaders to make emotional bond with their employees and patients while mentoring and coaching their team members (Cummings, MacGregor, Davey, Lee, Wong, Lo, Muise & Stafford, 2010).

Emotional and social intelligence

Competencies related to this approach generally consider those factors which separate the average leader from the great leader. However, ESI of the person improved with the time. In other words, it can be said that thoughts and feelings of the person are important in allowing us to influence others (NLP, n.d.).

Ethical leadership is the approach which mainly concentrates on the approach of the individual provider–patient relationship. However, delivery of patient care becomes predominant in team based and integrated across provider organizations. It must be noted that, these ethical frameworks of the health care system must consider micro- and macro-factors within the system. The broader issue in this context requires managers and leaders to supplement their ethical approach beyond the current and prospective patients. In other words, leaders must consider team, organization, and broader system of the organization where high standard of coordination and oversights are essential.

Administrators of the health care are also accountable towards the patients only but they are also accountable towards the team and system. They are under obligation to ensure how system is organized for the purpose of delivering and ensure quality care for patients (Ho & piney, 2016).

That healthcare entity which has complex system then even easiest term is getting more complex while handling. In this situation, it becomes difficult to manage the system in effective manner. It must be noted that in context of international dimension now health care entities which are considered as ordinary service sector, are now gaining more professional approach. Terms such as rights of patients, quality, etc are considered as important point of present health care institutions. Those health care entities which want to keep up with the time must ensure that their leaders have competencies and elements of strategic leadership. Strategic leadership is the concept which not only ensure effective strategic framework for the organizations, but also ensure efficient use of resources for maintaining framework (Budak & Kar, 2014).

Healthcare entities are considered as growing field, and as estimated by the U.S. Bureau of Labor Statistics job market in context of healthcare managers will grow by 16% in 2018. Health care managers have various important obligations such as administration of complete health care systems such as hospitals. Effective leadership in the healthcare entity depends on the type of management theory implemented in the organization. Some of these management theories are stated below (Lewis, n.d.):

  • Attribution theory is the way through which managers assess the success and failures of the health care systems and programs. As stated by the Patrick Palmieri and Lori Peterson's (2009), for the purpose of building safer health care system manager can use this theory because it ensures safer environment for the patients. However, this theory cannot be considered as fully developed management theory in context of health care.
  • Another important management theory in context of healthcare is based on evidence (evidence-based management). As stated by the K. Walshe and T.G. Rundall (2001), managers of healthcare slowly accept and apply similar theories from which they generally handle healthcare workers. This is the theory under which different professionals such as doctors, nurses and other healthcare professionals make decision on the basis of basis of best available evidences.
  • Third and last theory is the utilization management. This theory gets wider application in the industry of health care in comparison of other theoretical approaches. This is the approach which ensures management of healthcare institute through preset or predefined guidelines.

From many years, healthcare industry is engaged in the projects, but managers of this industry do not use any formal techniques for managing the projects. Now, these managers realized that for remain competitive, they must develop such skills through which they select and manage the projects in effective manner. Managers must realize that there are number of concepts related to the project management which help them in working with people daily basis (Bolman & Deal, 2003). Some advantages related to project management are stated below:

  • Project management ensures best control in context of human resources, physical resources, and financial resources.
  • It helps in improving the relationship with the customers.
  • It takes short time for developments.
  • It helps in reducing the cost related to the project.
  • Project management ensures high quality and increased reliability.
  • It also provides higher profit margins.
  • It improves productivity in the health care entity.
  • Ensures better internal coordination.
  • Boost up the morale of the workers.
  • Reduce the stress level.

Leadership ethics

Additionally, project management in health care entities ensure other programs such as embracing program and portfolio management for the purpose of meeting the requirements of the organization(Kathy, 2013).

A strong safety culture in the health care entity help the managers in reducing the medical errors, and it also encourage the leaders of the hospitals to take responsibility in context of patient’s safety. However, leading researches related to healthcare safety stated that few chief executives of the healthcare put the patient safety in their prior objective list and also allocate sufficient resources for improving safety level in the organization. At the same time, it is necessary for the leaders of the healthcare to learn how they can improve safety leaves in the entity. Strong safety leadership includes six important characteristics and all these characteristics are stated below:

  • It is necessary to set and clearly communicate the vision of the entity in context of safety.
  • It is necessary to value and empowered the human resource of the entity.
  • Must engage actively for the purpose of improving safety of patients in the organization.
  • Must lead by the example.
  • Manger must focus on the issues related to the system.
  • Organization continuously searches for the purpose of improving the opportunities (Singer & Tucker, n.d.).

Clinical governance is considered as a system through which healthcare entities are accountable in context of ensuring continuous improvement of the quality of the services provided by them and also ensure high standards of care related the patient safety. In other words, they are under obligation to develop such environment which ensures excellence in care provided by clinics.

It is an umbrella term which mainly covers those activities which help the healthcare entity in sustaining and improving patient care. Nursing staff may already be familiar with these activities and also ensure quality and safety improvement. It is the duty of healthcare organizations towards the community that they conduct such practices and activities which ensure quality and safety in the system. No matter which approach is adopted by the organization, they must provide evidences that standards adopted by them are high.  There are number of factors related to clinical governance and this mainly includes activities related to the quality improvement, risk identification and management, etc. As defined in the report issued by WHO, clinical governance divide the quality issues in 4 major areas (Crook, 2002):

(1) Efficient use of resources in the provision of health care.

(2) Manage the risk effectively which results from the service provided by the healthcare.

(3) Satisfaction of the patients while providing the service.

(4) Professional performance review (WHO, 1983).

Necessity in context of quality and safety improvement initiates pervades of health care. Quality for this purpose is defined as the concept under which services related to health in context of individuals enhance the chances of wanted health results. Following are the tools which can be used by the leaders for the purpose of providing quality service to the patients:

  • Advanced Implementation Quality Planning- this tool is used for the purpose of ensuring advanced services in the department.
  • Affinity Diagram- this tool is used by the organization for the purpose of generating, organizing, and consolidates information related to a product, process, complex issue, or problem.
  • Application of 5S- this new application helps the members of the team to develop a new enrollment template for the purpose of providing services.
  • Control plan- last but not the least, this is the plan which state written summary of actions, resources, and other requirements for the purpose of ensuring that process is followed properly (ASQ, n.d.).

Strategic leadership

Leader is also under obligation to frame such strategies and conduct all the operations of the health care system in such manner as it ensure effective productivity in the organization nada los ensure reduction in production cost. In other words, leaders of the health care systems are not only liable towards the patients and their only job is not only taking care of the patients, but they are also liable towards the organizations also.

Inter professional team is the means through which different professional of healthcare with diverse knowledge skills and talents work together for the purpose of achieving common goal. Leaders have opportunities to get best results for the healthcare by promoting coordination, collaboration, communication and decision making for the purpose of achieving best healthcare outcomes. This factor also increases the profitability of the organization and helps them in getting competitive advantage.

Patient empowerment can be defined as approach which inspires the patients to take active participation in health services provided to them by the health providers. The main purpose of authorizing the patients is to aid the patients in developing self-awareness and self-care and also promote the understanding that patients can be equal partners in their healthcare decision. This approach helps the leaders to promote the patient empowerment and engagement of patients in the decisions taking by healthcare entity. This increases the entity profitability and increases its reputation among patients.

This is the most important area and it directly affects the performance of the organization. Therefore, there is need to prepare such framework and policies which not only resolve issues but also help the entity in making the decisions of the organization.

Conclusion:

Leadership in health care organization is an approach which not only manages the work environment of the organization but also ensures safety of patients in the entity. Prime objective of leaders in health care systems are ensuring such satisfying values that results in high quality and concerned care for the patients. It is necessary for the leaders of the healthcare to learn how they can improve safety leaves in the entity. That leaders related to the best performing health care systems arranged a dream and also develop strategic framework for the purpose of focusing on proper care.

References:

ASQ. Quality in Healthcare. Retrieved on 27th March 2018 from: https://asq.org/healthcare-use/links-resources/tools.html.

Bezrukova, K., Thatcher, S. M. B., Jehn, K. A., Spell, C. S. (2012) The effects of alignments: Examining group faultlines, organizational cultures, and performance. Journal of Applied Psychology, 97 (1), 77-92.

Bolman, G. & Deal, E.  (2003). Reframing leadership. Business leadership. San Francisco: Jossey-Bass;. p. 86-110.

Budak, F. & kar, A. The importance of strategic leadership in healthcare management. Retrieved on 27th March 2018 from: https://www.researchgate.net/publication/317258400_THE_IMPORTANCE_OF_STRATEGIC_LEADERSHIP_IN_HEALTHCARE_MANAGEMENT.

Crook, M. (2002). Clinical governance and pathology. Journal of clinical Pathology ; 55(3): 177–179.

Cummings, G. MacGregor, T. Davey M. Lee, H. Wong, C. Lo, E. Muise, M. & Stafford, E. (2010). Leadership styles and outcome patterns for the nursing workforce and work environment: a systematic review. International Journal of Nursing Stud. Mar;47(3).

Garman, N. Brinkmeyer, L. Gentry, D. Butler, P. Fine, D. (2010). Healthcare leadership ‘outliers’: An analysis of Senior administrators from the top U.S. hospitals. J Health Adm   Educ ;27(2):87-97.

Ho, A. & Pinney, S. (2016). Redefining ethical leadership in a 21st-century healthcare system. Healthcare Management Forum, Vol. 29(1) 39-42.

Kathy, (2013). An Introduction to Healthcare Project Management. Retrieved on 27th march 2018 from: https://kathyschwalbe.files.wordpress.com/2013/01/healthcare-pm-chapter-1.pdf.

Lewis, J. Types of Health Care Management Theories. Retrieved on 27th march 2018 from: https://classroom.synonym.com/types-health-care-management-theories-2565.html.

NLP. Why Leaders Need Emotional and Social Intelligence. Retrieved on 27th March 2018 from: https://nlp-leadership-coaching.com/why-leaders-need-emotional-and-social-intelligence/.

Palmeiri, P. & Peterson, L. (2009), Attribution theory and healthcare culture: Translational management science contributes a framework to identify the etiology of punitive clinical environments, in Grant T. Savage, Myron D. Fottler (ed.) Biennial Review of Health Care Management: Meso Perspective (Advances in Health Care Management, Volume 8) Emerald Group Publishing Limited, pp.81 – 111.

Sawai, A. (2013). Leadership of Healthcare Professionals: Where Do We Stand?. Oman Medical Journal; 28(4): 285–287.

Singer, S. & Tucker, A. Creating a Culture of Safety in Hospitals. Retrieved on 27th march 2018 from: https://fsi.stanford.edu/sites/default/files/evnts/media/Creating_Safety_Culture-SSingerRIP.pdf.

Walshe, K. & Rundalle, T. (2001). Evidence-based management: from theory to practice in health care. Milbank Q. 2001;79(3):429-57, IV-V.

West, M. A., Lyubovnikova, J., Eckert, R., & Denis, J.L. (2014). Collective leadership for cultures of high quality health care. Journal of Organizational Effectiveness: People and Performance, 1, 240 – 260.

Woods, M., Baker, R., Charles, K., Dawson, J., Jerzembek, G., Martin, G., McCarthy, I., McKee, L., Minion, J., Ozieranski, P., Willars, J., Wilkie, P., and West, M. (2014). Culture and behaviour in the English National Health Service: overview of lessons from a large multimethod study. BMJ Quality and Safety, 23 (2), 106-115.

World Health Organization, (1983). The principles of quality assurance. Copenhagen: WHO.

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