Leadership in Healthcare: Theories, Application and Issues
EFFECTIVE LEADERSHIP IN HEALTH
“It is a truism that organisational culture is informed by the nature of its leadership."
Delivering the clinical care to individuals is mainly based on researches that are very careful. The researchers conducted help in the determination of the most efficient and effective ways by which the patients with health issues can be provided with appropriate care. According to Salas-Vallina, Lopez-Cabrales, Alegre & Fernandez (2017), there is a huge number of sums which are spent by Australia’s Department of Health. There is a need for understanding it clearly as what type of leadership and developmental procedures related to the leadership is much beneficial and has a good impact on the outcome of the patients. The task of leadership is to make sure that there is an alignment, commitment and direction within the terms of the organisation. The direction which is employed is purposeful towards agreeing with the people, the ones who are in relation with the organisational visions, strategies and values. There is a manifestation of commitment by all the individuals. They need to manage the responsibilities and should also make the success of an organisation their priority than individual success. This task gives us clarified ideas on the theories of leadership, their applications on different segments of healthcare, personal experiences in relation with the practices of health care, issues related to the leadership in health care and an interpretation of the logical overview on how leadership leaves an impact on the health services and individuals.
Question 1: Comprehensive overview of key leadership issues for the individual, healthcare teams and health services
Considering leadership, the hospitals are resembling organisations like those of the universities concerning their powers centres which are decentralised and diverse. The very commonly used model of leadership which was related to control and command is not applicable for these institutions now.
As opined by Olu-Abiodun & Abiodun (2017), the form which is recently being used and containing decentralised powers of the leaders are not meeting the very new challenges that have arisen in the leaders at healthcare. In the higher educations as in the cases of healthcare, the centre of powers is often getting siloed. With the proceedings of time, they are developing as professionals or fiefdoms based on specialities. For working more efficiently and making changes rapidly, the organisations are supposed to break their boundaries that are rigid. They need to break the barriers between the siloed ones. They must also focus on fostering the leadership from the employees of the healthcare.
According to Soklaridis, Kuper, Whitehead, Ferguson, Taylor & Zahn (2017), the Millennial has identified that there is power residing among each working in the firm. They have got the potential for the recreation of a scale that is micro. This will help every individual to become the leader of his fiefdom. The main issue which has been identified now is that these leadership skills of the potential leaders are being underutilised. There was a survey conducted considering seven thousand and five hundred millennials from across the world. It was estimated that 63 per cent of the total number of millennials revealed that their skills of leadership are not getting developed. The respondents who replied with the same were generally planning to leave the organisation they were working on.
The findings have posed a challenge for the employers in the firms of healthcare. The main issue which has been identified is that the departmental silos are replicating the top-down model which is outdated. There is an urgent need for the healthcare leadership to adapt itself to the practices of leadership which will eventually lead to a meeting of the values and needs of the millennials. The main purpose is a development of their capacities for leading as well as for being led simultaneously.
As opined by Carragher & Gormley (2017), the human resources departments are very well aware of the litany of the challenges that occur in the organisational culture due to the following of traditional methods of leadership. Some of the most perennial issues which have been noted down are- lack of engagements by the employees, increasing the level of attrition, higher levels of distrust etc. These issues generally revolve around the dynamics of the team and feedback on the performances of the employees in the healthcare, health services and to individuals in these organisational institutions. For the leaders of the company, the issues which generally arouses are also related to their decision-making capabilities. These issues are pressing in a typical way. Executives are needed to give a continuous work in the line which exists between for the poor choices, more precisely for lacking in deliberations and the opportunities which got missed due to higher amounts of deliberation.
The mix of the employee which is very new has complicated the satisfaction level of the employees as well as the decision-making capabilities of the team. As the millennials have occupied a share that is of a greater portion, the demands on the inter-generational basis for and on the leadership needs responses that are new from the formal leaders of these healthcare organisations.
However, the practices of new leadership are being developed. According to Strömgren, Eriksson, Ahlstrom, Bergman &Dellve (2017), there is a recognition of the fact that the responsibilities and the authorities get become much less concentrated when there is circular information in a freer manner. The practices which are being formulated will equip the leaders for harnessing the preferences of the millennials to adjust themselves to the cultures of the organisation with the more positive flow, engagement, accountabilities and better outcomes. If these skills are a parent in a millennial, it can be identified as a leader of a simultaneous kind.
According to Soklaridis, Kuper, Whitehead, Ferguson, Taylor & Zahn (2017), the very basic form of following and leading simultaneously is the substantial presence of the leaders on the moments of execution. The leaders along with themselves bring convictions and curiosities of the subordinates in the healthcare which are open to the distinct points of view. This curiosity and presence of the leaders encourage the members of the team to contribute more effectively. The leadership abilities convey an expectation to the subordinates in the health units that everyone will contribute genuinely to the different projects, conversation and the decisions which are on hand and relates to the wellbeing of the patients.
According to Strömgren, Eriksson, Ahlstrom, Bergman & Dellve (2017), when there is a warrant of the situations the leaders of the organisation should also be able to make decisions that are more authoritative in a way that will be accentuating trust. Another issue which is prevailing in the healthcare and health service units is that there is a lack of meetings. The millennials tend to avoid meetings which are necessary for benefitting the patients and for dealing with acute illnesses.
When there is a lack of training and structure, and no effective communication is taking place the model of leadership may seem inconsistent and haphazard. It seems that the healthcare organisations have unconsciously made backups into the following and leading model at the level which is structural. However, a harnessing of this diffusion is possible which will lead to more aggravating, productive and positive ends. This will happen through a treatment of the leadership that is resulting as a competency which is much critical.
Question 2: Impact of leadership on individuals and health services, includingcontemporary leadership theory and surrounding literature
Explicit theory: Theories are used for guiding the researches into leadership in the healthcare units is important to make sure that the constructs and the concepts which the research seeks for addressable are very much relevant and appropriate. Wong, Cummings & Ducharme (2013) conducted two literature reviews for systematic leadership in nursing. It also benefitted the outcomes of the patients. There was the identification of around twenty articles which had a quality of good methodology. Among these twenty articles, there were nine articles which were mainly based on the theory of explicit leadership. According to Nzinga, McGivern & English (2018), the theory of explicit leadership deals with the leaders who are usually appointed by the hierarchy. They have no direct link with the dealings of the health organisation. They explicit leaders mainly get training regarding operational issues in the healthcare.
Leader-member-exchange theory: D’Aunno and Gilmartin identified this theory in the year 2007. Their research revealed that this theory was not represented much properly the way it was in the literature of wide readership. Their researches have suggested that it has reflected certain behavioural reluctance. According to Strömgren, Eriksson, Ahlstrom, Bergman &Dellve (2017), the theory of Leader-member-exchange has revealed that the leaders inadvertently in the health care units create out-groups and in-groups. This is theory has an approach which is based on the relationship between the leader and the follower. There is a development of exchange with the subordinates. This kind of activities according to this theory influences the responsibilities of the subordinates, their decision-making capabilities along with access to the performances and resources. There is a chance of augmentation in the effectiveness of the healthcare with the help of this theory.
Emotional intelligence leadership theory: D’Aunno and Gilmartin have also stated that emotional leadership theory faces negligence in the literature concerned with health care. This theory is usually the management and understanding of one’s emotional quotient and the ones who are around. According to Lefevre, Lundqvist, Drevenhorn & Hallström (2017), it mainly deals with self and social awareness, self-management and the social skills which include the abilities to develop the other individuals, collaborations and team works, influencing, inspirational leadership and building of bonds.
Transformational theory: This is the most important theory which is having the maximum amount of influence in the guiding of leadership in the healthcare. From the researches which had been carried out by Wong and Cummings in the year 2007, it has been revealed that six out of those nine articles which used the theory of explicit leadership has used the theories related to transformational leadership. According to Grant, Studholme, Verma, Kirkwood, Paton & O’Connor (2017), the theory of transformational leadership deals with the activities of a leader where he works with his team for identifying the changes which are needed. He creates a vision for guiding the changes by inspiring his subordinates. He then makes execution of the changes with the help of the members who are very committed to the group of health care.
Authentic Leadership theory: This theory of leadership has focused on a very small number of studies which are related to the healthcare. This approach generally has emphasised on the building of the legitimacy of the leaders. According to Soklaridis, Kuper, Whitehead, Ferguson, Taylor & Zahn (2017), the health care has aimed at practising the same through relationships that are honest with the followers. They value the contributions which are made by the followers and behave ethically and transparently towards the subordinates. This act of trust leads to effective engagement and better team performance.
However, it has been concluded that the transformational leadership theory is the most identified theory which is concerned with the leader in the healthcare. The researches have stated that the theory of transformational leadership can very effectively support the studies which are concerned with health care. According to Whitehead, Dittman& McNulty (2017), they have also identified links with the satisfaction of the staffs, team and unit performances, and the climate of the organisation and intentions of the turnover. There are several effects of transformational leadership which are concerned with the relations of balance in the work life, wellbeing if the staffs of the health care, nursing outcomes which are positive, the safety of the patients, openness to errors and the satisfaction of the staffs along with the patients.
Nurse leaders: There are a large number of researches and studies which are concerned with the nurse managers and the nurses. There is a very strong relationship between the managerial style of the nurses and the satisfaction of the staffs the retention and the turnover. According to Alghamdi,Topp&AlYami (2018), nurses generally prefer managers who are very participative, emotionally intelligent and facilitative. These styles were also linked with the cohesion if the team, lower level of stress, a higher level of self-efficacy and empowerment. The empowerment of the nurses for bringing about the improvement of good quality has also emerged from the literature of health care.
Medical leaders: From the reviews of the models of medical leadership it has been assessed that the partnership between the general managers and the medical leaders is one of the most important factors. As opined by Carragher & Gormley (2017), doctors are most of the times engaged in the works within and between the organisations. It has been reported that the ones who have the maximum number of engagements performs better than the others. Their performance has been assessed in the measures which deal with the level of performance within the organisation. The trusts who are high performing and the activities of the interviewees has resulted in medical engagements at a very high level.
Team leaders in health care: A team that works effectively is a very importingfactor for the success of an organisation. According to Arnold (2017), team leadership has been suggested to the health care’s most important because they usually have poor management of the centres. In the year 2003, there was an analysis by few researchers which considered the reactions of 3447 respondents, who belonged from 98 health care teams were primary, 113 teams of mental health community and 72 teams from breast cancer care units. The results from this analysis revealed that there was a clarity in the leadership which had an association with the objectives of the team, higher participation levels, commitment towards excellence and support towards innovation.
Board leadership:There are a certain number of imperial researches which are associated with the board leadership. McFadden, Henagan& Gowen III (2009)founded that the leadership style of CEO is having a link to the outcomes of safety related to the patients. In the year 2008, it was revealed by a few researchers that the activities or practices of the board had an association with better level of performances. As opined by Olu-Abiodun & Abiodun (2017), these performances were regarding the care of the patients and the rate of mortality.
Organizational leaders: The research which has been conducted by Shipton, Armstrong, West & Dawson (2008) have revealed that the top management which was concerned with the team leader makes positive prediction about the level of performances in the hospitals. The analysis was made by considering the response of five thousand five hundred and sixty-four individuals from thirty-three different hospitals. The organisational leaders are positively and very strongly associated with the governance of the clinics and complaints of the patients if any. They are also having an association with the star ratings of their health care and the satisfaction level of the patients.
It has been concluded that leadership is identified to be very critical to the provision of healthcare. In this task, numerous kinds of literature and examples have been taken into consideration for elaborating the impacts of leadership on the individuals, health care teams and health services. We have discussed the theories related to leadership in healthcare, the types of leaders who are present in healthcare and their provincial contribution to the unit. We have recognised the ways of development based on the identified issues in the health care centres. We have taken into consideration the contemporary leadership theories and their application in the healthcare services.