Management in Health Studies - Metropolitan Private Care Home - Case Study Example

Management in health studies Introduction Management refers to all business activities that are concerned with planning, organizing, coordinating, staffing, leading and controlling in the organisation. The management sets up the organisational structure and assigns authority and responsibility to the subordinates. Planning entails setting the organisational goals while leading involves articulating the vision of the organisation in order to attain the organisational goals. On the other hand, leadership refers to the process of influencing the efforts of the followers towards attainment of a shared goal and objective. Management is the practice of reaching organizational objectives by working through and with people and other resources (Burns and Sinfield, 2012). The definition of the term management is based on two ideologies the significance of resource and people and commitment to achievements (Burns and Sinfield, 2012). This implies that people are the most critical resources for having things done. The importance of management is necessary and universal and in indispensable for all types of organizations. This paper will discuss the importance of proper management and leadership in organisations. The paper will utilise a case study of Metropolitan Private Care Home that is experiencing poor employee training, high nurse turnover and poor organisational culture. Every organization requires the coordination of activities, the making of decisions, evaluation of the performance, and the handling of activities (Eby, 2000). SWOT analysis (strength, weakness, opportunities and threats) is a strategic planning, which matches internal organizational strengths and weakness with external threats and opportunities. By conducting SWOT analysis, a useful strategy for attaining objectives becomes evident. In the health industry, strengths include the availability of trained human power and resources. Weaknesses include obsolete facilities and lack of managerial talent. Threats include growing cost of vital drugs and cultural believes towards current medical practice. Opportunities in the health practice include supportive and clear government policies and the availability of a functional health committee in the society. Strong leadership is probable the single most critical driver of well constructed talent management and overall organizational performance (Eby, 2000). Succession planning and talent management are essential in health care sector where leaders confront unprecedented pressure to change their organizations. This paper is an analysis of (situational, transactional theory path goal/ transformational theory) and practices relevant to management in health studies. The problem to be analyzed using various theories is based on a case scenario of Metropolitan Private Care Home, which is currently experiencing difficulties handling a mental health patient. Evidence (Nature of the Problem, What Is Happening, How it is A Problem, What Could Be Done, How to Address the Issue, Solution, Training Solution SWOT Analysis Strength and Weakness of the Organization,) Nature of the Problem: Metropolitan Private Care Home is experiencing problems of poor employee training, high labour turnover and lack of enough knowledge and skills among the nurses. There were challenges after the mental health nurse called in sick n the morning making it hard to attend to a mentally sick patient. The organization is served by two categories of nurses namely mental health nurses and general nurses. Unfortunately, the mental health patient diagnosed with schizophrenia is likely to receive poor quality care in the hands of the general nurse who lacks the knowledge and skills to handle the patient. The problem can be attributed to poor human resource policies that hinder training and development of nurses. In addition, the organisational culture hinders collaborative working practices. The nurse shortage has led to decline in the quality of health care and inefficiency in the health care delivery process. What is happening and how it is a problem: The organisational culture is not based on ethics since assisting the mentally sick patient is becoming hard owing to his unbecoming behavior of refusing to cooperate i.e. refuses to eat and behave aggressively after the general nurse took over from the sick colleague. The work environment does not support cordial working relationships and teamwork in the organisation. What could be done and how to address the Issue: it is critical for the manager to address the problem in a way that satisfies the patient’s demand for quality service. The short term solution to the low quality nursing care delivery can be solved by calling an agency to cover immediately. In the long term, the organisation must train and develop the nurses in order to improve the quality of nursing care. The organisation can also implement a buddy system or shadowing in order to solve the problems facing the nurses and patients in the health facility. SWOT analysis of the problem Facing Metropolitan Private Care Home SWOT analysis is a tool, which helps managers in organizations spot out the strengths, weaknesses, opportunities and threats facing their organizations (Eby, 2000). Understanding of SWOT at Metropolitan Private Care Home is paramount for strategic planning both presently and in the future. In terms of strengths, the organization has qualified mental health nurses and staffs that work as teamwork. Weakness in this scenario is the limited number of qualified mental health nurses. However, lack of sufficient mental health nurses is an opportunity for the organization to embark on rigorous training programs that target general nurses. Adequately trained mental health nurses safe the organization cost of agency (hiring a mental health nurse) 13700- 14600 pounds annually. Threat associated with inadequate mental health nurses are poor quality services, which frustrates patients. The organization is likely to attract sharp criticism or competition from other agencies. Relevant Theories (Situational, Transactional Theory Path Goal/ Transformational Theory) In Relation To the Case Study (Metropolitan Private Health Care) Situation Theory Situational theory explains that different situations needs different leadership style that adjusts to conditions of the situations (Adair, 1988). Metropolitan Private Health Care is facing unusual situation where there are insufficient mental health nurses to handle mental health related cases. Based on situational theory, the manager need to get a comprehensive understanding of the leadership he ought to incorporate in this situation. Hersy and Blanchard established their situational leadership early in 1969 based on 3-D management style theory by Reddin. The major responsibility of the situational leaders is mainly to adapt their leadership style so as to satisfy the members’ needs. The mentally ill patients seek proper attention and quality services from the mental health nurses, which is not forth coming. Therefore, the manager as a situational leader is expected to accurately diagnose the willingness and skills of individuals and prescribe tasks that balance their commitment and competency to execute the assignment. To achieve this, it is imperative to recruit additional mental health nurses to address the present problem, and initiate a training program for future undertakings. A situational leader is expected to continually balance the direction given with enhancing relationships since peoples’ motivations and skills change over years (Barker, 1996). The leader must try to balance high touch and high technology in these dynamic times. Leaders must communicate clearly; have good judgment, and passion. Situational leaderships should be flexible and quickly adapt to circumstances, characters and changing scenarios (Chief Secretary to the Treasury, 2003). The key strength of situational leadership rest on the fact that it is flexible and directive in nature; in essence, the model guides the leader on how to address different situations. In this case, the manager at the Metropolitan Private Care Home is flexible enough to rely on general nurses, though the outcome is likely to be wanting due to their low quality services. Alternatively, the manager is free to initiate a training program that will equip general nurses with the desirable understanding and skills to deal with the problem. Leadership entails change and this form of leadership is based on adjustment to change. Internal and external pressures coerce people and goals to change; thus, situational leaders must quickly respond to emerging changes (Eby, 2000). Situational leadership though prescriptive, is flexible as it guides the leader on how to responds to follower’s desires and needs, in the work place. It is obvious that the general nurses would appreciate training programs that equip them with skills to handle mentally challenged patients. Situational leadership acknowledges value differences among members and the nature of individual work; hence, improving performance. Situational leadership has withstood a moderate test of time. This leadership has been employed in family, educational and heath settings over the years. The major shortcomings of this theory that may be impediments to the manager at Metropolitan Private Care Home are eminent. The challenge of situational leadership is that it calls for incredible judgment based on human assessment and task knowledge (Eby, 2000). Not everybody has the character, vision, perception, tenacity, luck, constituent buy in or strength to lead in all situations. The manager in the Metropolitan Private Care Home requires views from staff members for the firm and reliable decisions. Misdiagnosing the follower’s willingness or ability to complete duties disrupts the group’s progression and frustrates the follower’s self esteem. Both overstating and underestimating the group’s abilities are harmful to goal achievement. The misdiagnosis of commitment and readiness of multiple group members leads to project failure. A focused situational leader needs to be educated in psychosocial and cognitive development theory in order to understand employees’ influences of age, gender, racial and cultural identity (Eby, 2000). Situational leadership approach requires the leaders to be familiar with the development and intellectual level of the team members. Application of this theory makes it harder for the leader to know all employees of the larger groups. Path Goal Theory Pathgoal theory was originally developed by Robert House to teach on leadership (Belbin, 2010). The theory is anchored on two approaches of work motivation namely expectancy and goal setting theory. Goal setting approach explains that an efficient way to motivate people is by setting challenges, but remaining realistic to the goals and providing rewards for the accomplished goals. Expectancy theory expounds on why people work hard to realize their goals. People usually engage in behaviors, which leads to the attainment of goals if they are persuaded by an increase in pay, promotion or status (Eby, 2000). If employees do not appreciate the reward of goal achievement or are persuaded that their conduct is unlikely to achieve the desired goals, then they feel unmotivated. Pathgoal approach argues that effective managers help their subordinates to achieve their goals (Eby, 2000). According to this theory, leaders have a duty to provide their followers with support and information necessary to realize their work goals. Therefore, leaders should reward relationship by linking favorable results to goal attainment. The Pathgoal theory is a reflection that the leaders clarify the appropriate path for their subordinates to follow if desirable outcomes are to be registered. Leaders are required to engage, in activities, which help subordinate to attain their goals by providing resources and information (Eby, 2000). Further, leaders should remove obstacles, which hinder employee’s pursuit of their goals. Being a contingency theory, Pathgoal theory proposes that successful leadership is contingent on the managers’ adoption of a particular behavior that reflects the needs of the subordinates. The theory categorizes four leadership behaviors, which help followers in attaining their goals and they include supportive, directive, participative and achievement oriented leadership. Supportive leadership is about being considerate of the subordinate’s needs and establishing a conducive working atmosphere. Directive leadership helps subordinates, in understanding what is expected of them, by providing clear guidelines, procedures and rules in their work. Participative leadership involves subordinates in decision making processes by encouraging them to offer suggestions. Achievement oriented leadership sets challenging goal and emphasizes on the need for excellence in performance. The choice of leadership style depends on environmental factors such as (task structure, work group, authority) and individual factors including experience, abilities and personality. Pathgoal theory makes various predictions regarding the best style of leadership in particular situations and depending on types of subordinates. Supportive leadership is more effective when the work setting is dreary, dangerous and stressful. Supportive style in such situations increases subordinates fulfillment and self confidence and minimizes the negative aspect of the environment. This increases the intrinsic valance of the task and the expectation that it will be implemented accordingly. Directive leadership according to Pathgoal theory is effective when people are uncertain on what duties they have to perform (Flynn, 2002). Participative leadership is recommended in unstructured situations as it increases task clarity and suits people with high needs to manage their environments. Achievement oriented leadership is prescribed in complex work environment since it increases subordinates confidence that they can meet the expected outcomes. For leaders to be effective they need to appreciate the needs of the followers, satisfy their needs through reward, and help subordinates in identifying appropriate paths (Flynn, 2002). At Metropolitan Private Care Home, the rewards and support are reciprocated through encouragement of teamwork and training programs. The manager enforces teamwork as an essential asset where a general nurse can sit in for a sick mental health nurses; thus, fostering unity. All personnel are encouraged to work together as a team as a combination of different strengths helps in reducing individual weaknesses. Training programs at the Metropolitan Private Care Home increases staffs’ knowledge and skills regarding mental health problems. Through training, nurses will be able to minimize accidents while attending to their patients and feel more confident in their duties. According to Pathhgoal, the manager at Metropolitan Private Care Home is obliged to set challenges to the nurses, which if successfully executed leads to more job confidence and motivation among the nurses and other health practitioners in the profession. Transactional Theory This is a theory that focuses on getting the job done, and if the job is done there is a reward, and if not there is a punishment. This is theory usually work well when implemented properly. Transactional theory analyses human behavior and personality. It is a systematic tool for personal development and growth, interpersonal behavior and intra psychic functioning. The techniques of transactional analysis theory are designed to help people change and understand their behaviors and feelings. In 1958, Berne Eric an American psychiatrist formulated transactional theory and ensured that people have a basic core that is lovable and have the desire for self actualization and growth (Flynn, 2002). Individuals have the capacity to decide their own destiny and their decisions can be changed. Individuals acquire both intellectual and emotional insight via transactional analysis. Basically, transactional analysis is usually contractual implying that work is done through contract. Contract involves agreement between the client and counselor, which outlines the stages, condition and goals of the treatment (Gill, 2006). During the contract period, the counselor develops his adult ego states. Contracts can often be established to alter feelings, psychosomatic and behavior problems. Contracts can be between groups, individuals, or between groups and individuals. The formality of contracts requires clearly spelt terms of engagement that are binding to both parties. Proper contract ensures the process is goal oriented. In transactional theory, ego states are fundamental as they help individuals to express their personality. People behave feel and think differently because of various ego states that are distinct and separate sources of behavior (Gill, 2006). Based on this theory, the manager at the Metropolitan Private Care Home is in a contract agreement with the staffs i.e. general and mental health nurses. Therefore, execution of tasks should be in harmony with the concurrence of the contact. Employees are rewarded in terms of decent pay for their good performance while punishment involves suspension and warning in case of breaching the term of the contract (Gill, 2006). Successfulness of the manager in adopting training programs largely depends on his cooperation with the nurses. Ethical values Culture Policies Democratic and Management styles Regarding Management in Health Studies Ethical values and culture Ethics refer to the expected standard of behaviors for human beings and involves the study of moral behaviors and values (Gill, 2006). Ethical behaviors involve acting in a manner, which is consistent with individual, organizational and society values. The moral motivation is usually rooted in three moral systems namely empathy, principles and moral affiliations. Sources of ethical standards include the utilitarian approach, the rights approach, the common good approach, and the virtue approach. Utilitarian approach stresses the need for people to do good and least harm (Kadushin, 1976). The right approach insists on the necessity to revere and protect the moral rights of others. The common good model is about the welfare of everyone. The virtue approach emphasizes that action should be in accordance with ideal virtues for the progression of humanity. The codes of ethics outline principle and standards of the ethical practice of public health. A conduct of ethics provides the key beliefs and values intrinsic to a public health perspective upon, which the ethical principles are anchored. The World Health Organization (WHO) understands health as a state of complete mental, social and physical well being rather than merely the absence of infirmity or disease (Flynn, 2002). There are various principles of the ethical practice of public health including humans’ right to access resources necessary for human health, and are inherently independent and social. The effectiveness of organizations depends on the public’s trust; collaboration is fundamental to public health, and that knowledge is powerful and influential. Humans needs companionship in families, community and friendships and rely upon each other for survival and safety. Positive relationships among institutions and individuals are signs of a healthy society. Factors contributing to trust in an organization include truth telling, communication, accountability, reliability and transparency (Flynn, 2002). All these virtues should be cultivated in Metropolitan Private Care home if trust is to be enhanced among employees. In regard to collaboration as a key element to public health, collaboration among professionals and agencies is necessary to overcome a myriad of challenges in this sector. Lastly, knowledge in public health is powerful and beneficial as it improves the understanding of the health and the means to protect it through research and development. Further, there is a moral obligation for professionals to share information in policy making processes. The manager of Metropolitan Private Care Home needs to build leadership skills for decision making based on organizational values and ethics. Through ethics and values, the manager is able to identify the real problem, map out the consequences of the decision made, and select the best choices and properly implement the plans i.e. training programs for the mental health nurses. Management styles The style of leadership adopted by a manager is dependent on the needs, personalities and situation of the employees, and the prevailing organizational culture (Flynn, 2002). Due cultural changes and organizational restructuring, the management style of an organisation changes with time (Kadushin, 1976). In recent times, most organizations increasingly adopt management styles that favor empowerment and team work over authoritarian styles. The management styles where the leader acts as a technical expert in directing, coordinating and controlling employees have been replaced by management styles that emphasize coaching, counseling and team building. The most effective management styles focus on team building, building networks of relationships among employees and motivating others (Flynn, 2002). In most organizations, there is an emphasis on people management or soft skills and participative management styles. Participative management involves sharing information with employees and involving them in critical decision making processes (Flynn, 2002). Employees are urged to coordinate their respective departments, in addition to assisting in decision making, regarding policies and processes. In order to perform such tasks, employees must have abilities like, technical and communication skills and the intelligence required to communicate decisions effectively. Though, achieving a healthy relationship between employees and managers can be challenging, it is essential in assuring employees of their security and appreciation. A non-conducive workplace experiences high levels of absenteeism, high levels of attrition and low motivation. On the other hand, a supportive leadership style ensures that practitioners in the health profession are provided with the necessary resources and information (Flynn, 2002). In reference to the manager at Metropolitan Private Care Home, there is a need to adopt a supportive leadership style that guarantees mental health nurses full support. Policies and democracy Policies are critical in the achievement of goals and health standards. Such policies include equality in distribution of health interventions, a participatory approach that allows the delivery of interventions, social accountability, effective utilization of health technologies and a sectoral approach to utilization of health goals. When access to health interventions is distributed equally, social and exclusion disparities are avoided (Kadushin, 1976). All members of the society should have equal access to the services irrespective of caste, age, color, gender and geographical location. The policy of equity emphasizes gender equality, non-discrimination and, social accountability and inclusiveness. In relation to people centered service, health interventions are based on people’s legitimate expectations and needs (Kadushin, 1976). Therefore, the community must be involved in implementing and monitoring health programs. For effective utilization of health technologies, a policy must be adopted that requires the use of existing technologies especially those that are accessible, affordable and culturally acceptable. Social accountability involves the realization of quality standards of health by bridging public perceptions, public participation, transparency and performance reporting (Kadushin, 1976). Democracy, civil liberties and political rights are variables associated with health status (Kadushin, 1976). In this respect, democratic societies allow organizations to discharge their duties freely by liaising with government agencies for funding and legislation (Kadushin, 1976). In the case of Metropolitan Private Care Home, the manager has invented a democratic system where a meeting with all staff is convened, and his plans about the current situation are discussed. Democratic leadership is preferred in resolving the crisis as it is a collegial style which is very open when running a team. Through the democratic style, the manager is able to communicate efficiently, and all information is circulated to all departments. Recommendation and conclusion The manager at Metropolitan Private Care Home is caught in a tricky situation where a mentally ill patient is repulsive to the services of the general nurses. The organisation lacks sufficient mental health practitioners to handle such cases especially during emergencies. It is recommended that the manager engages the services of an agency in order to protect the credibility of the company’s services. However, the cost of such a plan is high as it costs the company 300 pounds for a day shift. It is, therefore, recommended that the company adopts a training program that equips the existing staff with skills to handle such cases in the future as this will cut down expenditures on the long term. Various management theories that guide the manager on how to react to different situations exist and he is at liberty to utilize them appropriately. The decision reached by the manager should be guided by organizational values, policies, ethics and culture. Understanding of SWOT at Metropolitan Private Care Home is paramount for strategic planning both presently and in the future. Strong leadership is probably the single most critical driver of well constructed talent management and overall organizational performance (Eby, 2000). Succession planning and talent management are key in the healthcare sector where leaders confront unprecedented pressure to change their organizations. Bibliography: Adair, J., 1986. Effective Teambuilding. Gower Publishing, London Adair, J., 1988. 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