Leadership in the Health Care
Discuss about the Building Organizational Capacity in Health Care for Leadership.
There is an increasing amount of awareness in the importance of leadership in the field of healthcare. Most theories of leadership were generally formed for the setting of the business and then were applied to the field of healthcare. However with increasing complex situations, the health care organizations are starting to recognize the importance of leadership practices. This paper aims to identify the roles of the leaders in bringing about the change in the workplace environment. It further discusses about the leadership styles and implementation of the change using the change management models. Additionally the barriers of change that is faced is mentioned in the paper along with the facilitators of change, and what the leaders are to do for proper flow of the change.
The behaviour of any person which includes directing activities in order to move forward towards a goal is called leadership (Al-Sawai, 2013).The major aspects of leadership includes influencing the activities that requires to be conducted in a group and coping with any kind of change that is required in the workplace. When considering the case of health care professionals it is seen that the concept of leadership is both that well developed among the healthcare setting. Even studies show that very little evidence exists for the leadership initiatives taken for the improvement of the patients or the organizational developments (Aarons, 2015). Within large organizations such as the medical organizations, the need of leadership is desired which requires to capitalize on the notion of diversity in the organization as a whole. The emergence of leadership will also help in efficiently utilizing the resources while designing the processes of management along with encouraging individuals to target towards some common goals.
There lie various leadership approaches that can be adapted to the settings of the health care in order to effectively optimize the system of management in an environment which is largely complex. The approaches of leadership include collaborative leadership, transformational leadership, shared leadership, conflict management, ethical leadership, distributed leadership, and healthcare leadership whose results is functional oriented (Carter, 2013). The theory of transformational leadership puts emphasis over the working of the people more efficiently with an established sense of mission. It is required for the leaders to initiate communication of their vision in such a way that is, exciting, meaningful and develops unity and a nature of collective purpose within the community of individuals. The context of collaborative leadership plays role when a cooperative procedure occurs and each and every individuals try to work collaboratively for their mutual benefit. It involves information for the communicating with the co-workers and associated organizations, so that they can initiate in making their own decisions that are informed. This joint strategies of communication elevate and facilitate the healthcare management by initiating encouragement of conversation among multiple stakeholders; knowledge sharing and experiences; and furthermore decrease in the level of complexity that is present among healthcare settings (Ginter, Duncan & Swayne, 2018). Conflict is seen as a persuasive force that exists among the organizations of healthcare and as gaps in the development of communication, there exist higher probability of failure in the practices at the workplace. The leader of healthcare must thrive to implement some of the suitable approach for initiating handling of conflict in all the stages in order to create a positive outcome for all who are involved. Shared leadership reflects a system of management which is of team-level or the leadership that enables to give power to the staff in the processes of decision-making. Shared leadership generally results in the adoption of leadership behaviours of individual staff members, greater autonomy, and improved outcomes of patient care (Marquis & Huston, 2015). According to distributed leadership theory, the goal of the leader is to initiate formation of an ethos whereby the individuals are enabled to complement towards individual’s strengths and offset towards one another’s weakness, with the quality of leadership distributed throughout the environment or the field of organization. Practicing effective leadership tends to have significant effect on the healthcare staff regarding their employment life, outcomes of the patient, and an organizational fate. A good and an efficient leader must therefore have goals, behaviours and values that will not bring any harm and will always tend to respect the rights of all the parties. This concept is included on the notion of ethical leadership.
Role of Leadership in the Organizational Change
Some of the categories of challenges which clinicians face while dealing with the complex setting of the services of modern health care include: requirement of diverse changes, rising expectations of the patients, and accelerating cost of treatments and new interventions. The main focus by the functional results-oriented leadership style on the organizational process imply specific role of the concept of leadership and required skills that is necessary for the effective delivery of the targeted results of the group on the basis of fulfilling the requirements of the three areas that includes individuals, tasks and the team (Mosadeghrad & Ferdosi, 2013).
For the proper workplace functioning and performance of an organization effective leadership has become very important. Leaders who are intelligent enough show skills and knowledge for effective and efficient management of the tasks required on a daily basis in the workplace environment. In order to bring about effective changes, efficient leadership skills is of prime importance. This requires competent leadership that can be put to use for handling and managing problems arising in a workplace (Seo et al., 2012). A competent leadership has the ability to manage the knowledge and other skills and capabilities.
For the development and managing a change, it is very important for the leader to create a favourable atmosphere within the workplace. A suitable atmosphere is also required in order to adopt the change within the organization. In the development of change in any workplace, the workplace culture also has a role to play (Thomas, 2015). It is the leader who becomes responsible for bringing in new strategies for the effective development and management of the culture. Strategies can be implemented to interconnect the people involved in an organization. The workplace culture includes several values and beliefs that is may change the organization from being conservative to innovative. For effectively managing technologies, two dimensions of leadership skills should be accessed namely transactional and transformational leadership (Taplin, Foster & Shortell2013). The focus of transactional relationship is on managing the technological changes that needs to be brought about. Transformational leadership on the other hand mainly focuses on the need of technological changes along with the consideration of the human relation factors. This form of leadership helps the leader in portraying the role of a pathfinder and communicating the visions through proper exercising of skills. According to some studies, transformational leadership is more effective for the organizations to develop a change in the workplace environment and implementing innovations (Carter et al., 2013).
Importance of an Organisation’s Vision, Mission and Strategic Goals when Considering Workplace Change
To understand the importance of leadership and the need of workplace change, it becomes very important to understand the essential concepts of mission, vision and the strategic goals of the organization. The mission of the organisation is the prime reason of its existence. In case of a health care organization, the mission should be provision of high quality care to the patients or the consumers. Existence of a clear mission is required for the proper guidance of the leaders to take major decisions and choose between alternatives (Goodwin, 2013).
The conceptualization of the future is referred to as vision. The vision helps to navigate the organization towards a better future. A systemic formulation of the vision is essential based on the terms of scientific advances, demographic trends and technological innovations in the respective fields. For example considering the field of cardiology, it can be seen that with increasing of the age of the population there is a prevalence of more calcific aortic stenosis. Along with this the innovations are implemented of trans-catheter aortic valve replacement (TAVR), which are able to motivate the leader to arrange the implementation of this new technology into practice. This should be done in consideration of the consequences on surgical volumes, staffing needs, and organization finances and facilities (Hayes, 2018).
The concept of strategy puts forward the plans that the organization tends to follow for becoming successful and providing competition to other organisations in the similar field. The strategy that it being followed for the achievement of this vision include the development of a team of physicians who are nationally renowned and work in a multidisciplinary manner. Furthermore emphasis is also given on broadly developing their reputation (Greenfield, 2007).
In order to bring out changes with maximum effectiveness, it is desirable that the leaders understand the workplace culture. Good leaders are able to provide an impact on the long-term culture and values of the workplace by implementation of self-modelling of behaviors. Additionally creation of cultural expectations and communication of the cultural expectations formally is also required. For example in case of maintenance of expectations and showing mutual respect, a demonstration can be professed by the leaders even in times of complex situations (Marquis & Huston, 2015). It is required of the leaders that they show mutual respect in such times, instead of letting the situations go unaddressed. This helps in providing a positive workplace culture.
As discussed by several theorists, there are different styles of leadership and each of this style has an impact on the change management. According to Aarons et al., (2015), in the Leadership Model for Change Management, the Transformational leadership aims in promoting the organizational development. The leaders can be visionary change agents who needs to be more skilful and motivational. Such leaders are able to sustain the operations within an organizational by which specific personal actions combined with perceived personal characteristics can be implemented (Andrews, Cameron& Harris, 2008). It is the duty of the leaders in the change management model to lead to bringing out of change by helping to develop the skills that help in facilitating to accustom with the changes. Leaders in order to become successful in bringing about change have to focus on the launch, ways of implementation and sustenance of the particular change effort.
The process of change management needs to consist of various skills like leadership development and communication skills. In case these are lacking then it will have a negative impact on the effectiveness of change management process in the workplace. The leaders needs to possess the factors such as strong determination to make the change happen, perseverance, stamina and first-hand intelligence. In absence of a strong leadership, implementation of organizational change is not possible. It is desired of the leaders that they should be able to lead the team for managing the change and making the team adapt to the changes that is brought into the existing system. Due to change there is a transformation in the environment or the culture of a workplace therefore the leaders, being the agents of change have to oversee the process so that they can provide a supportive response towards the change. The visionary leaders are expected to bring about quality-led strategic change (Cameron & Green, 2015).
Several models of change management have been developed recently from the context of healthcare. ‘Lewin’s Change Management Model’ is the example of one such model that includes the elements such as the field theory, action research, group dynamics and the three major procedure of change (Hayes, 2018). The concept of field theory projects the idea that maintenance of the current situation is carried out by a full set of the symbolic forces which has an effect on the group structures. This in turn can influence the behaviour of the individuals. According to Lewin’s theory, change is considered to be the consequences in the forces among the respective field of symbols. Therefore, recognition of those forces enables the understanding of the motives of the people and helps initiating influence of the behaviour of the people. For the identification the forces of field of a given situation, the theory proposed looking to the subjective (cognitive) and the objective (behavioral) aspects of the life’s group. The circumstances would involve the groups and subgroups that are included, their targeted relationships with one other and their system of values together with their social habits (Mosadeghrad & Ferdosi, 2013).
The individual behaviour is generally constrained by group pressure, as claimed by the concept of group dynamics. Thus, the focus should therefore be given at the group level instead of the individual level. The research of actions illustrates two aspects as the following. Firstly, it is required for the individuals to feel the requirement for change, that involves the capability to understand the momentary status quo of one and the gap compared to the desired status quo of the future. Next, one of the most appropriate solutions at hand should be implemented and chosen. This scenario consists of the evaluation and continuous analysis of all the possible measures (Son et al., 2011). Finally, according to Lewin, in the context of complete change management, the procedures can be differentiated among three steps namely ‘Unfreeze, Move, and Refreeze’.
One of the familiar procedures was to be “unfrozen” by the act of sensitizing the participants of the process towards the requirements of change and by overcoming and evaluating their defence mechanisms. The next or the second step that is the (Move) targets towards effectively strengthening all the required changing forces. This is because of the change to actually take place. The final step that is the (Refreeze), that initiates reinforcement on the maintenance of the acquired status quo which is newly acquired for deterring the participants. This causes initiating reversion towards their initial state (Taplin, Foster& Shortell, 2013).In accordance to the above discussion, Lewin’s model of change management can be capable of structuring a workplace change project in the health care setting.
In a study conducted by Tannenbaum, Weschler& Massarik, (2013), the author illustrated the ‘Lewin’s change management models’ namely, group dynamics, the field theory, action research , the 3-step model, in the context of the health care setting for initiating changes in the cost unit accounting system at a teaching hospital in German.
The main aim of this study was to highlight and analyse the documentation of the accurate costs which are associated with the periods of patient care system. In the light of the Lewin’s field theory, the change initiators were recognised with the aspects of the environment related to health institution This represents the forces and the driving attire for initiating change that are restraining in nature. For the identification of the necessary actions for obtaining support of the senior hospital officials, group dynamics were analysed. Some of the examples include administrators, board of directors, medical and directors of nursing. Furthermore staff and workers might act as alteration opponents. Effective understanding of the dynamics of the group initiates the allowance of change initiators for hosting the workshops that targets for informing all stakeholders for the change requirements. Example includes formation the feeling of requirements and to give them an opportunity for effective contribution towards the change and the planning initiative.
Finally, the ‘3-step model’ was utilised to effectively implement the initiatives of the change. This resulted in the formation of an ‘unfreezing stage’ in which workshops were carried out for informing the staff of the nursing regarding the need for approach of new documentation. Next, the move stage, in which the concept of new documentation was set in for production and all the teams were initiated the extra support for accommodating the changes. Lastly step, the ‘refreezing stage’, in which feedback opportunities were initiated for ensuring that the required and the targeted concerns were addressed efficiently (Thomas, 2015). The case study described in this assignment highlights a well-structured and a comprehensive example of the theories of Lewin’s change management and highlights their capability to usher for the alteration within the healthcare organizations.
Change taking place in the workplace may be a planned change or an emergent one. Most of the times the organizations opt for the changes of the incremental type as it is better suited for minor modifications or improvements. The organizational change tends to involve everyone involved in the organization, therefore there is a requirement for the alignment of the individual goal along with the organizational goal. Although the organizations emphasis more on the controlled factors while bringing about change like resources and technologies, sometimes the human part of the change is ignored. These leads to the cause of barriers. The barriers of change tend to come from these major sources: the organization that is targeted for change, the change that needs to be initiated and the lastly the employees who are affected by the change (Parris & Peachey, 2013).
Some of the barriers that is faced by the leaders who are the agent of the changes are lack of clear understanding of the change that needs to be brought about. Often people also fail to understand what change is with respect to their workplace. To overcome this the leaders from the starting should make the definition of change clear and compelling. Sometimes there is an issue of insufficient Active Change Leadership. It is critical for stakeholders to be expressing, modelling, and reinforcing consistently their personal and collective commitment to the change (Martin & Waring, 2013). This includes Executive leaders down through the middle layers of the organization. There is also a problem of resistance to change. In such cases the agent should try to use the opportunity of resistance to try and gather project feedback instead of training and communicating the way out of the resistance.
Poor communications is one of the major factors of change barriers. There is a general belief that getting a mere message towards the audience can be more than enough for buy-in, eliminating resistance and the drive of the behavioural changes. The lenders should centre their efforts on the communication of the right message towards the audience which will include the feedback loop so the t the reactions are gathered properly (Al-Sawai, 2013). Lastly there is the problem of lack of Rigorous Governance for Transformational Changes. The structure of the governance should be able to provide a sight of clear line from the strategy to the portfolio and then the programs, projects, and sub-projects. If the stakeholders don’t have this sight line then there are high chances of the lack disciplined management by the transformational change project. The leader should oversee that there is a consistent process for implementing change in order to facilitate the flow of change.
Conclusion
Many theories and models that have initiated influences on the strategies of leadership are applicable currently in the setting of healthcare management. In case of effective leadership settings, the guidance should target or aim over the connection and the relationships among the values of leadership, capabilities, culture and the context of the organization, which should be dynamic in nature. Development of leadership has reached a critical point and thus the most essential role of a leader that could be described is the proper ensuring of a ready supply of the replacement leaders for the maintenance of the organizational procedure and the progress within the ever-changing environment of healthcare.
References
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