Introduction
Leadership has been signified as the behaviour of an individual while directing the activities of a group towards the effective completion of shared goals and objectives. The fundamental determinants of leadership role primarily involve influencing group activities and contesting with developments and change. Leadership is identified as a critical component for any organization aiming to drive developments and improvements in healthcare excellence and patient safety (Hargett et al., 2017). Healthcare delivery systems tend to shift from volume based towards value-based systems whereby leaders experience new and varied challenges which necessitate better ideas, behaviours and performance. Healthcare systems are primarily constituted of numerous professional groups, sections and expertise with intricate, complex nonlinear interactions between them. However the level of complexities related to such systems typically as considered as unparalleled because of certain constraints related to various disease areas, multidirectional goals as well as multidisciplinary employee base. Within wide range of organizations such as healthcare organizations, numerous groups comprising subcultures might align or engage into conflicting situations with each other (Ginter, Duncan & Swayne, 2018). Leadership thus requires efficiently benefiting from the diversity within healthcare domain as whole and proficiently utilizing resources while arranging management processes and further acknowledging personnel to advance towards share aims and objectives. The following paper primarily evaluates the leadership styles and techniques in healthcare domain and shed light on key leadership issues for healthcare services. In addition to this, it will further analyse the impact of leadership on healthcare services.
Discussion
An important attribute of good leader is the competence to essentially explore individualistic and team motives in attaining transformation or perceived vision of success. Healthcare professionals should possess an insight into leadership the techniques and responsibilities to successfully obtain in-depth understanding of the characteristics and skills required for underlining ‘leaders’ within the organization (Patel et al., 2016). Leadership further has been perceived as a fundamental role within new nursing and allied healthcare professional domain. Thus it has become no longer justifiable for healthcare professionals to avoid distinguishing the value and implication of effective leadership in contemporary healthcare environment (Ginter, Duncan & Swayne, 2018). There can be witnessed that wide ranging developments essential within healthcare domain cannot be implemented using doctorial management techniques which tend to strengthen change using ‘top down approach’ (Patel et al., 2016). Healthcare professionals must essentially possess adequate leadership competencies in diverse healthcare organizational settings in order to implement developments based on good clinical decision making and pertaining to patient-centred approach to care (Shanafelt et al., 2015).
Effective leaders in healthcares services fundamentally emphasize on continual protected, improved quality and compassionate care to the major priority. Leadership techniques further ensure that the voice of patients must be consistently taken into consideration at every level such as while dealing with patients’ concerns, demands, suggestions and experiences. Individual leadership primarily aim to offer supportive, accessible, empathic, justifiable and empowering leadership and further encourages involvement, participation as their core leadership strategy (Wang, Kung & Byrd, 2018). Furthermore individual leadership techniques seek to emphasize on transparency in relation to errors, critical incidents, grievances and complains and tend to perceive these areas effectual for attaining comprehensive understanding about healthcare leadership techniques (Frich, Brewster, Cherlin, & Bradley, 2015). On the other hand, clinical leadership in teams create a strong sense of team value and identity by efficiently ascertaining distinctive as well as inspiring vision of team’s performance and also focuses on sound commitment towards collaborative diverse teams and diverse-boundary performance (Shanafelt et al., 2015).
It has been observed that for centuries there has been witnessed much areas of discussion and arguments related to the most efficient leadership approach to successfully implement economical healthcare exposure for millions of Australians. Clinical leaders in contemporary times experience unconstructive situations in seeking resolutions for multiple complex issues which further exhibit propensity to impact the ability to efficiently implement cost-effective programs, initiatives and sustain productive operations and services to support other healthcare initiatives. The future of organisational sustainment in healthcare fundamentally requires highly proficient leaders to strategize for any potential areas of challenges. Recently healthcare leaders have been encountering a plethora of challenges and complexities (Wang, Kung & Byrd, 2018). These areas of challenges include regulatory and policy changes, ethical dilemmas along with medicinal and technological advancements. Frich, Brewster, Cherlin, & Bradley, (2015) state that clinical leaders must efficiently comprehend a combination of challenges which could rapidly and proficiently consume time and economic constraints for medical services. (Lin, MacLennan, Hunt & Cox, (2015) have observed that technological progress tends to pose additional challenges with programming, controlling as well as support issues.
At this juncture issues related to elevating rising expenses of healthcare have been taken into consideration. As more and more people strive to live longer and lead healthier and energetic lifestyles, the extent of healthcare challenges and concerns. Further research has revealed that healthcare expenses have been increasing at a rapid pace resulting to a strong elevation in exceeding inflation and has further the potential to increase in the future. Healthcare services in Australia has indicated that aggregate healthcare expenditure has risen at an average rate of around 6% from 2015 and has been considered as higher than the anticipated annual increase in the gross domestic product (GDP) (Boamah, Laschinger, Wong & Clarke, 2018). These situations have thus led clinical leaders to seek emphasis on offering provisions for their employees. It is essentially crucial for healthcare leaders to seek alternative tools and approaches in order to successfully combat the increasing expenses of care. Furthermore, modern practice of medicine and technology has been creating critical challenges and complexities in the way healthcare providers have been offering services (Hornstein, 2015). Healthcare organizations in contemporary times have been encountering clinician deficits and lack of low-cost alternatives in patient care. Al-Haddad & Kotnour, (2015)argued that the pressure and increasing influx of patient data as well as legal demands and requirements for stringent privacy and security along with the rapidly progressing clinical technology has been raising costs and expenses of healthcare services. These critical forms of issues and challenges have been creating critical dilemma for clinical leaders to seek efficient ways to manage proficient ways of offering healthcare services (Trastek, Hamilton & Niles, 2014). Thus studies exploring leadership techniques in healthcare sphere posited that leaders must effectively comprehend and assume the behaviour of systems and further provide vital knowledge and expertise to inform potential developments (Mosson et al., 2018).
Ethical dilemma and intricacies in healthcare has been perceived as a critical determinant. Reports reveal that many modern healthcare leaders have been using unethical means and approaches of providing misleading medical services which often led to higher casualty level. Furthermore on the other hand, healthcare providers are ethically proscribed to enter into the personal sphere of patients in the course of efficiently offering healthcare services (Hornstein, 2015). They are typically perceived to be positioned at situations of risks and threats for being accounted for malpractices and clinical negligence. Patients who have been affected by malfunctioning or defective medical equipment or services during the course of clinical therapy due to certain types of medication errors which can litigate to recover the losses often sue clinical providers thus leading to unconstructive outcomes (Aarons, Ehrhart, Farahnak & Hurlburt, 2015). Leadership in healthcare domain typically necessitates wide range of clinician engagement along with forms of citizenship behaviours within the arena of healthcare services. This area of engagement as per Johnson & May, (2015) tends to intervene into the consideration of clinical leadership. It is further to note that professional progress and development has been distinguished as one of the major determinants in clinical leadership. Healthcare leaders often experience critical forms of dilemma and challenge to efficiently evaluate, develop and attain essential personal as well as professional capacities in order to sustain high level of proficiency and expertise. Tistad et al., (2016) note that major proportion of training initiatives has been constrained with customary clinical interview with its primary emphasis on acute illness and disorder; however clinical leaders will be contested to alter to change that dynamic. Thus leaders engaged in healthcare domain would essentially necessitate employing practical approach and integrating patients in health care treatments.
With the current focus on inter-professional problem solving techniques for efficient healthcare services, intense collaboration emerges as a major factor in offering exceptional treatment and care and leading clinical projects. Intrinsic in inter-professional association has been recognized as a requisite which each theoretical discipline tends to share an understanding of similarities as well as a universal language of change process (Mosson et al., 2018). Extensive rate of language intricacies and variation in healthcare perspectives an intervention model has been implemented to seek mutual ground for understanding so that each discipline sustains an influence. Since decades, broad range of healthcare professionals has been proposed to use Lewin’s Three Step Change Management Model to efficiently sustain developments and transitions in healthcare organizations (Al-Haddad & Kotnour, 2015). Healthcare organizations are extensively complex adaptive systems exhibits transitions which are regarded as complex process with varying extents of challenges and agreement among disciplines. Cummings, Bridgman & Brown, (2016) denote that Lewin’s ‘Unfreezing’ stage is regarded as the first stage which essentially includes organizing the healthcare enterprises to embrace developments which are highly essential. Healthcare sectors in order to successfully prepare professionals efficiently must initiate from the core and contest perceptions, values, standards and behaviours which would signify their attributes (Ram-Liebig et al., 2015). However, it is critical to note that the initial part of change process typically tends to exhibit immense criticality and challenges and must evoke strong responses in healthcare professionals to understand the primary determinants of change process.
Furthermore, the second stage of change model is created following to the level of uncertainties generated during the previous stage. The shift from unfreeze to change in healthcare organizations does not tend to occur at a rapid pace which results to clinicians to gradually adapt new course and further engage in the process of change management. However in order to productively embrace transitions and facilitate clinicians understand its beneficial factors this stage is highly essential (Bakari, Hunjra & Niazi, 2017). Time and communication are identified as two significant factors to changes occurring in a successful manner. Clinicians while sustaining forms of change requires an extensive rate of time and effort along with practical management competencies. Lastly, with the roughly organized changes, the healthcare organizations develop the ability to refreeze (Cummings, Bridgman & Brown, 2016). However, the outward indicators of the refreeze stage are identified as consistent organization chart and further necessitate healthcare organizations to facilitate professionals to successfully internalize as well as incorporate transitions and developments. The rationale for developing a new sense of consistency in the ever-changing world is often being questioned (Ram-Liebig et al., 2015). It is important to recognize that any change process devoid of refreeze stage would get into transitional ensnare which emerges high level of uncertainty about things which need to be executed in utmost capacity. With the wide ranging efficiency, Lewin’s change management model had undergone certain form of criticisms related to deficit in terms of accountability for the interaction of healthcare individuals, teams and organizations.
However in addition to change theory, contemporary healthcare sector has shifted to certain other theoretical conceptualization of leadership. Specifically transformational leadership theory seeks to emphasize on change process whereby leaders who implement such techniques are recognized as transition agents (Hornstein, 2015).. These change agents further use their excellence and attributes in order to acknowledge their followers to efficiently share ideas and visions and further empower them. Drawing ideas from transformational leadership theory it has been observed that clinicians at the primary stage organize appropriate and adequate time to patients to ensure providing utmost dignity and trust to others (Trastek, Hamilton & Niles, 2014). Transformational leadership is further about contesting the status quo further creating a comprehensive and sharing those relevant perspectives and ideas while being highly consistent and determined to stimulate momentum towards change (Hornstein, 2015). Furthermore, healthcare leaders exhibiting transformational leadership techniques tends to align facets of ‘self-knowing’ with ‘emotional wisdom’ and further emphasizes on ideas related to emotional intelligence where prospering transformational healthcare leaders have attained the ability to enthuse others. Hughes et al., (2016) state that thus there can be witnessed an inter-reliance of followers and leaders within this theory which implies that transformational leadership has seek favour in sphere of care-centric as well as learning fields. Author has stated a classic example of Florence Nightingale who exhibited true transformational leadership skills in the field of healthcare and therapeutic treatment. Tistad et al., (2016) observed a crucial correlation between ideas of transformational leadership and innovation within the healthcare labour force. In the study of Australia, it has been recognized that clinical leaders who exhibited transformational leadership styles have been perceived to put additional effort and further attaining greater degree of satisfaction and efficacy. While this has been significant that transformational leadership has attained substantial degree of prominence because of its relation to formation of vision and embracing transitions without empirical evaluation transformational leadership constrains the approaches through which transformational leadership techniques can be conceptualized in healthcare settings (Mosson et al., 2018).
Transactional leadership theory primarily signifies as the antithesis of transformational leadership and further denotes that transactional leadership competencies prevail in areas constituting exchange relationships between leader and followers. Trastek, Hamilton & Niles, (2014) noted that role of transformational clinical leaders fundamentally sheds light on the aim of the organization. Leaders underlining transactional leadership skills facilitate people to efficiently recognize determining factors to accomplish desired outcome through process of reward and penalty motivator (Hornstein, 2015). It has further been signified that transactional leadership as a form of skill and capability tends to contest with mundane, practical, operational and regular dealings of healthcare organizational life. Healthcare professionals exhibiting transactional leadership abilities need to manage such ordinary organizational dealings with utmost efficiency and further to retain their creditability and productivity (Trastek, Hamilton & Niles, 2014).
However criticisms associated to this form of leadership theory primarily relied on significant procedures, technical expertise and accurate information to inform decision making process. Transactional leadership has further been signified as form of ‘scientific managerialism’ which depends on the relative conjectures (Cameron & Green, 2015). These assumptions however reveal that transactional leaders tend to be sited in the position to control rewards and assertively recognizing leaders. Aarons, Ehrhart, Farahnak & Hurlburt, (2015) state that though with its wide ranging expertise, transactional leadership theory similar to transformational theory have experienced certain level of criticisms which state that human behavioural pattern is stimulated by factors of motivation for recognition and incentive procedure and due to its greater degree of inclination towards highly conservative aspects rather than inventive (Hughes et al., 2016). However, the underlying principle of transactional leadership relies that clinical leader in order to efficiently perform must enable themselves to regulate any forms of situational contexts within which they are expected to take primary roles and positions and further manage healthcare environment and restraining transitions (Johnson & May, 2015).
Conclusion
The types of challenges and intricacies that healthcare leaders experience while leading highly complex situational contexts of contemporary healthcare services primarily incorporate diverse and altering demands and requirements along with elevating rate of patients’ experiences and expectations and high cost of new interventions as well as therapeutic care. These situations however need clinical leaders to primarily consider needs of broader range of patient population and efficiently execute clinically-led service developments which are typically to progress. To conclude it can be stated that several theories and models have influenced contemporary leadership strategies and theories which can be relevant to the clinical setting. Significant assistance needed for effective leadership skill should emphasize on the dynamic associations between leadership values, standards, ideologies, culture and competencies. Clinical leadership development has successfully attained a decisive crossroad and the major role of healthcare leader can be signified as ascertaining effective involvement of replacement leaders to sustain organizational advancement in the ever-changing healthcare domain.
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