Leadership Styles Of Director Of Social Services - Dissertation Example

Prospectus Leadership styles of director of social services: Effects on psychosocial well-being of nursing home residents Prospectus: Leadership styles of director of social services: Effects on psychosocial well-being of nursing home residents Problem Statement There is no shortage of manuals and prior studies that show practices and actions that welfare and social services managers should do or how they should act. Issues such as the factors that make a good leader, the effective leadership traits and investigations regarding the nature and impact of authority have all been discussed extensively. However, the literature that explores the link between leadership styles or behavior and the improved performance and high quality of service in nursing care are still scarce. There are often instances where residents’ psychosocial care has been neglected because the people being hired for leadership positions have neither the qualifications nor the experience to do the job (Ford, 1997). In 2011, the International Association of Gerontology and Geriatrics confirmed this, further adding that there is a crisis of leadership in nursing home practice because employment for care professionals in these institutions are often equated with low prestige, leading to inadequate supply of professionals capable of meeting the demands of nursing home residents (Tolson, et al., p. 185). This trend is unfortunate because studies demonstrate that knowledgeable and effective leaders are critical in addressing challenges in the operation of a healthcare establishment such as those related to organizational culture and structure (Grabowski et al., (2010). There is an increase in scholarly attention with respect to the relationship between leadership style and the quality of nursing care, but empirical studies are still in their infancy. This theme is, of course, comprehensively covered in other fields, particularly in business and healthcare industry. However, there is an imperative for specificity. Effective social services administration calls for a model or a standard leadership framework that would lead to the identification of managerial abilities, strategies and behavior that positively impacts the incidence and quality of organizational/institutional outcomes. So the question of interest involves whether leadership style(s) positively impacts the well-being of nursing home-residents. Research indicates that substantive control by the administrative leader on the care, quality, and services have significant impact on the psychosocial well-being on nursing home residents (Allen, 2008). Success in nursing home care depends on the performance of the management team. Lately, there are changes that have occurred in nursing home care that support leaders in making decisions that inspire confidence towards the new approaches to leadership (Sullivan-Marx & Gray-Miceli, 2008). There are now documented evidences where leadership styles impact the quality of care institutions. For example, it was found that the right leadership style has the potential to encourage health care providers to connect with the organizational values which, in turn, facilitate growth in employees’ performance in the work place (SWPI, 2010). This is confirmed in another study by Morrison, Jones and LaDon’s (1997) where the link between transformational leadership with employee retention and the improvement of care was established. The leadership style was found to empower nurses, which, in turn, lead to job satisfaction – the variable that result to improved quality of patient care. The dynamics of power, authority, influence that characterize several leadership styles were also identified as strong predictors of employee retention across several health care institutions (Boyle et al., 1999). Other studies also show a strong connection between staff turnover rates and the quality care of nursing home residents (Martins et al, 2009; Siegert et al, 2010). Here, issues that impact employee turnover rate that affect the quality of care for nursing home residents were revealed. These include the bond between the nursing care residents and the healthcare providers, difficulty in establishing trust and the lack of continuity of care. Leadership styles were also found to have bearing on the outcome of conflict management and management effectiveness in a cross-sectional survey conducted among head nurses (Hendel, Fish and Galon 2005). Clearly, a leadership style – as demonstrated by the transformational leadership framework - can create positive behaviors among management team members, which definitely impacts on the psychosocial well-being of health care providers (Allen, 2008). The “psychosocial well-being” concept in this study refers to the comprehensive concept of well-being of patients that include physical, mental and social well-being. As the World Health Organization explains, this is important because there is the consideration of “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (Ahearn, 2000, pp. 4). The study, hence, refers to the three components when citing “psychosocial well-being”. Background This study draws insights from various sources, prior works that highlight the need for further research in nursing care and the role of leadership style in improving psychosocial welfare of nursing residents. One of the examples is the work of Siegert et al., (2010), which outlined the broad needs of patients who are present in nursing homes. This study revealed that health problems range from dementia to palliative care, indicating a diversity of health problems requiring different solutions and care such as the improvement of psychosocial well-being of residents. This highlighted an imperative for meaningful management approaches. Based from the work of Luker et al(2000), there are different leadership models that that have been applied to nursing homes. The diversity in achieving quality of care levels is problematic not just because of the sheer number of factors to be evaluated but the differences in frameworks as well. The body of literature makes it difficult to identify models that truly work for nursing care. Most of studies undertaken involved theorizing and opinions of experts, which underscore the need for evidence-based study on the subject. There are scholars who recognized this gap. For example, Pearson et al. (1993) showed the numerous areas that have been studied for the purpose of establishing the quality of care in nursing homes. He, however, indicated that organizational leadership has not been investigated in detail. Thus, he reveals that even with a large amount of research being directed at nursing homes’ quality of care, there is still scanty research on the impacts of the leadership style and organizational structure of nursing homes. This is supported by other studies. Fahey et al. (2003), in an observational study of the quality of care for elderly residents in nursing homes pointed out that the current body of literature, including their own work is not comprehensive enough, lacking data and insights on certain aspects in nursing care such as how well the care professionals relate to patients or with respect to the nursing care residents’ expectations of care. Significance The gap in literature with respect to the leadership styles of directors of social services and their impact on nursing home residents is critical because it underpins a shortage in evidence-based sources that could help learners, professionals and policymakers identify the skills to effectively manage nursing homes, particularly in terms of managing its social service component and in maintaining the well being of residents. By identifying the impact that a social service director has on psychosocial wellbeing of nursing home residents, this study is able to contribute to the identification of best practices that could form part of standards in nursing home management. Furthermore, this study provides a better understanding and insight as to why healthcare institutions hire qualified directors of nursing and social services with strong leadership styles to improve the psychosocial well-being of the nursing home residents. Theoretical Framework The theoretical framework for this study follows the systems theory, which considers the organization as a complex system, consisted of group of people that have to work together in order to produce results. Royeen et al. explained that, in this model, the organization is a generalization of reality where the various parts of the system have functional and structural relationships between each other and a degree of integration insures that they work together (p. 55). Here, a driving force is considered necessary and leadership functions as one. The Systems Theoretical Framework can further be augmented by organizational theory, which explains the behavior and dynamics in individual, group and organizational contexts (Royeen et al., p. 54). A combination of systems and organizational theory depicts a model whose pathway should explain an effective managerial strategy that use team, collaboration and importance of leadership in influencing outcomes. The following model (Fig. 1) based on system and organizational theories depict how leadership impact the achievement of organizational objectives such as the improvement of psychosocial welfare of nursing care residents within a complex system that involves several actors and conditions. What the model depicts is a process of achieving a desired outcome such as improved organizational performance. This is also the model that explains organizational change wherein the organizational culture is reoriented towards the provision of better quality of care. In this study, the goal of the process is the improvement of psychosocial welfare of nursing care residents and its realization depends on several variables within the organization. Leadership is the point of convergence so that they work together. Fig. 1: Theoretical Model Research Questions The research study will be guided by the following questions:- RQ1 – What are the leadership styles of directors of social services as applied in nursing homes? RQ2 – Is there a link between these leadership styles and improved psycho-social well-being of nursing home residents? Nature of the Study This research employs qualitative research methodology. The data collected will be interpreted objectively and deductive reasoning will be used to draw findings, conclusions and recommendations. Several qualitative tools will be used. The phenomenological approach is the primary research technique used in this study as it perfectly suits the data collection and analysis relevant to in answering the research questions. This approach values the experiences an individual has had. It resonates with nursing values of respecting people and striving to understand them. The best approach that takes these into account is, thus, the phenomenological approach. This research aims to determine the various leadership styles in nursing homes and the effect the various leadership styles might have on the psychosocial well-being of the individuals receiving care at the nursing homes. The phenomenological process will allow the investigation of the research issues through the exploration of the participants’ experiences. These experiences will be linked to leadership through the triangulation approach, which will be discussed later. For this purpose one of two qualitative approaches are proposed: focus group interview or a qualitative questionnaire with open-ended questions for the directors of social services and care providers. Both of these are considered excellent sources of qualitative data (Brown, 2001, pp. 212). These tools will include structured questions designed to extract accounts of experiences and self-reflections (Reid, Flowers & Larkin, 2005). The data collected will constitute the primary sources that will be evaluated according to the phenomenological model designed by Schweitzer (1998). The model is consisted of six stages: Stage 1: Intuitive/Holistic Understanding of Raw Data Stage 2: Forming a Constituent Profile Stage 3: Forming a Thematic Index Stage 4: Searching the Thematic Index Stage 5: Arriving at an extended description Stage 6: Synthesis of Extended Descriptions (Holroyd, 2001, pp. 2-3). To adequately answer the research questions it is crucial that the experience and views of the research participants be taken into consideration (Peipert, Gifford & Boardman, 2000). The above phenomenological method is designed to explicate experience. The raw data will be organized according to thematic codes. The thematic analysis segments the data into “thought units” or codes so that themes and their significance are identified (Nilson, 2009, p. 233). This is expected to be supported by the fact that the interview is structured for a methodical analysis. Through the phenomenological approach, this study shall examine the qualities of experiences of the nursing care residents. Its goal is not to develop a model or a theoretical framework but rather to provide accurate descriptions of the director’s or the patient’s “lived” experience that is relevant to the topic under discussion. The chief rationale of the research will be to determine whether the presence of a Director of Social Services with effective and strong leadership style results in improved psychosocial well-being of nursing home residents. The qualitative methods employed in this study can offer sufficient information that can describe variables, relationships and insights that could inform decision-making in improving the quality of nursing care. Possible Types and Sources of Information or Date On site interviews will be conducted on directors of Social Services and care providers at different nursing homes located in the states of Virginia. The data will be augmented by information from residents’ medical charts, as well as from the residents’ responses that evaluate their physical, psychological and emotional well-being. This researcher also proposes to interview members of care providers. These will enable the researcher to obtain important data from different nursing homes, analyze and eventually create new data on how leadership designs of the directors of nursing, as well as the social services positively affect the psychosocial well-being of nursing home residents. The data collected from the interviews with the directors of Social Services, care providers, nursing home residents and medical records are the source for triangulation. Flick defined triangulation as the method of taking different perspectives and combining them in order to produce knowledge on different levels (pp. 184). Jick (1979) provided several important case studies that apply this strategy in different fields. It was pointed out that this “mainly qualitative” tool is the cornerstone of multi-method investigations since it provides the framework for convergence. The triangulation of compiled data and analyses is expected to lead to better confidence in the validity of the research results. References Ahearn, F. (2000). Psychosocial Wellness of Refugees: Issues in Qualitative and Quantitative Research. New York: Berghahn Books. Allen, J. (2008). Nursing home administration (5th ed.). New York: Springer Publishing Co., LLC. Boyle, D.K., Bott, M.J., Hansen, H.E., Woods, C.Q. and Taunton, R.L. (1999). Managers leadership and critical care nurses intent to stay. American Journal of Critical Care, 8(6), 361-371. Brown, J. (2001). 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