An Analysis of Personal Leadership Development in the Health Care Sector - Literature review Example

An analysis of personal leadership development in the health care sector BY YOU YOUR SCHOOL INFO HERE HERE The health care role and team challenges My role in care provision is that of Ward Manager within a Respiratory and Endocrinology Department. It is my responsibility to coordinate activities associated with the hospital ward, including procurement of supplies, monitoring and controlling expenditures, recruitment and training, auditing, ensuring compliance to various regulations and policies governing staff behaviours and investigating a variety of disparate complaints. The most significant aspect of the role is to establish the highest standards of evidence-based care provision through effective management of data, human activity, and achievement of high staff morale through effective leadership practices and ideologies. In this environment, in order to meet stringent standards of care quality, the Ward must operate as a system, inter-dependent group activities to identify problems and ensure that patient needs are managed productively and within an acceptable response period. Change, in this health care organisation, is relentless as the hospital introduces new best practice procedures which, in some instances, radically alter the methodology by which certain job role activities are performed. In an environment where emotions invariably run high and where the pressures for provide excellence under new change procedures are considerable, change resistance has been a fundamental problem in the role of Ward Manager. Staff members in teams, when they disagree with a new change practice, will provide irrational and unreasonable commentaries about why a particular change is practice is not feasible or should be reconsidered. Ford, Ford and D’Amelio (2008) assert that such groundless or irrational resistances are commonplace in an environment where new change practices conflict with an established way of doing things in the organisation. In one particular change resistance scenario, senior hospital administration had conducted an in-depth benchmarking study on a variety of hospitals that were receiving accolades for excellence in quality of care provision. Supplemented with a feasibility study conducted by higher management, it was determined that employees should be trained with knowledge related to conducting independent audits of their own role environments to facilitate a more holistic approach to identifying failures or non-compliances in key areas of service provision. This was a marked change from established policy in which audits were conducted solely by management and employees immediately began illustrating resentment and frustration over additional pressures for recording data and reporting it to the Ward Manager and other relevant management. Offered one particular employee exhibiting substantial resistance, the process was ridiculous and attempted to assert that these new practices would cause patients to become angry for being disturbed at unusual hours whilst the audits were being performed. The argument in this case was completely unjustified by the nature of the new processes. The leadership ideology in the organisation was to ensure that employees maintained the perception of personal empowerment in their job roles as a means of fostering more organisational commitment and motivation. However, employees viewed this new independent auditing practices to be an illustrating of management distrust in their job role competencies and felt their power was being threatened by having to procure important auditing data. Kim and Kankanhalli (2009) iterate that when employees feel their power is being endangered, they will tend to build coalitions to gain solidarity toward resisting an unwanted change, which was exactly what was occurring in the ward. Employees felt that by building such coalitions, it would dissuade management from implementing policies associated with compliance to auditing practices in key areas of operations and service delivery. Resistance coalitions were eroding the quality of relationships between management and employees, building animosities and mistrust that had not previously been a challenge in an environment that had, prior to this particular change, been productive in a group environment where there was considerable faith and reliance in the talents of one another. As a result, this had a moderate trickle-down effect that began impacting the motivational state of staff (and managers) and began impacting responsiveness toward fulfilling patient needs. The volume of patient complaints rose by approximately 30 percent, which required a substantial examination of what would constitute a solution to this erosion of team productivity and emotionally-charged resentment occurring as a result of disfavour for the new auditing practices. Exemplary leadership requires having the capacity to inspire a vision that is shared by all team members (Kouzes and Posner 2012). In this particular instance, the conviction of staff members toward the vision of continuous quality had been eroded and leadership was faced with enormous challenges of re-establishing such convictions and rebuilding a cohesive culture that was more flexible about resistance and could regain important socio-psychological relationships. An analysis of leadership and future leadership development My role as Ward Manager demands excellence in leadership, with the organisation’s most significantly ideology being that of transformational leadership. A transformational leader is one that inspires a vision, consistently reiterates this vision and role models desired behaviours (Bass, et al. 2003), whilst creating open lines of communications to facilitate more effective feedback and interpersonal relationship development. Utilisation of these strategies, admittedly, has been a challenge in an environment where inter-professional relationship quality was being eroded as a result of the aforementioned problem with auditing compliance resistance. Considerable efforts have been placed into exhibiting role modelled behaviours and inspiring a vision of total quality management, however employee resistance and animosities about auditing practices conflicted being able to gain commitment and loyalty toward this vision. A recent informal appraisal of my leadership performance from higher-level administration indicated that I was not significantly effective in building a cohesive organisational culture and that I should be more diligent as a role model to gain a fundamental desire in staff members to emulate these actions. I disagreed with this feedback, however, as I made legitimised efforts to be more upfront about addressing all of the concerns of employees using an empathetic stance, which is reinforced by Skarlicki and Folger (1997) that this approach can lessen change resistance when it occurs as a result of perceptions that new changes will impact autonomy or share decision-making. However, the theoretical was much different than the real-world outcomes achieved using this strategy. Employees seemed to appreciate that I made an effort to address their concerns (whether somewhat justified or completely irrational), however it would not inspire a deep commitment to the organisation itself, only enhance some degree of trust toward me as the role of leader. In critical self-reflection, perhaps the feedback coach offering me advice about how to more effectively role model behaviours was more critical to leadership development than simply utilising an empathic approach. Under social learning theory, when individuals witness the behaviour of another being rewarded, they are more apt to adopt this behaviour (Grusec 1992). Hence, from a personal development perspective, over the next year I will blend the concept of vicarious reinforcement with transformational leadership, whereby I will work on developing a publicised enthusiasm for the auditing process (and other changes being resisted), whilst encouraging my superiors to extol my accomplishments in observation of staff members. However, my most significant leadership weakness is having a more assertive and confrontational approach with senior managers to discuss new leadership initiatives. If an effort toward building an effective leadership model of vicarious reinforcement is to be successful, I will need the enthusiasm and commitment of senior-level managers which will require inquiry and consultation inter-professionally to justify that this might be an effective leadership approach in a very difficult and quality-eroding team environment. Assertive leadership behaviour is the process of clearly communicating ideas, expectations and beliefs in a way that is direct and honest. Managers that fail to illustrate assertiveness can be viewed as weak leaders as they do not present that they have the initiative and commitment to take charge (Ames and Flynn 2007). If I am to gain commitment to my superiors taking interest and approving implementation of my own leadership strategies, which I genuinely believe to be viable models based on relevant foundational studies and theories, I will need to develop the assertive leadership personality. I intend to review empirical studies and various theories on how to improve assertive behaviours. In this environment, many other strategies to reduce change resistance in staff members have been attempted, but failed to achieve the return on investment that they intended to inspire. By learning about best practice assertiveness behaviours and then applying them experimentally in a real-world environment, it should improve not only my confidence in approaching superiors, but also facilitate what I believe will be more effective in reducing change resistance and building a cohesive culture of performance and quality vision where most strategies have failed. I had, historically, attempted to utilise the transactional leadership approach whereby when certain communicated performance targets had been achieved, employees understood what type of reward or recognition they would receive (Antonakis, et al. 2003). However, ultimately this failed to achieve the type of return on investment expected of this particular style of leadership. Staff members found the rewards too insignificant for the tasks expected or felt that I was setting to high of performance targets that were not achievable without substantial effort. This is an area of leadership that requires development over the next year. I have decided that I would consult with employees, using attitude surveys or informal discussions, about what types of rewards they would deem appropriate based on my existing stringent policies and objectives. This type of leadership is justified by the Servant Leadership model, whereby shared decision-making is a fundamental aspect (Farazmand, Green and Miller 2010). I have an inherently-high level of self-efficacy, believing in my own capabilities to solve problems and find solutions using my own self-motivated competencies without reliance on the opinion and efforts of others. Self-reflection identifies that this level of self-efficacy can be a detriment to group functioning. I believe that by exploring models of how to implement a servant leadership ideology in an organisation (such as looking at empirical studies), I can build an experiential model that would facilitate more motivation, commitment and trust from staff members. By consulting them about transactional rewards, it will illustrate a deeper appreciation for their competency and opinion-generating capabilities, which could underpin a more trusting environment and cohesion at the organisational culture level. Grieves (2010) states that change must be negotiated if it is to be implemented effectively and various resistance removed. As illustrated, leading improvement is one of the most significant and primary goals of an organisation that is focused on quality control and quality improvement. As a leader, working with a plethora of diverse staff members with multiple cultural heritages and talent backgrounds, no singular leadership style is going to be effective in achieving organisational goals, motivating performance, and creating more high quality outcomes. Therefore, servant leadership, transactional leadership, and aggressive styles of leadership require more examination and experimentation to determine if they can build cohesive sets of norms and values, inspire commitment, and ensure more flexibility in the face of continuous change. As a result, over the next year or two, I experimentation of different approaches to leadership will be necessary to determine which aspects would be most effective at my particular organisation and which are not relevant or feasible for the diverse staff members working within the ward. The coalition-based culture of change resistance that has been built at the organisation cannot be undone overnight and will require the talents and ambitions of a flexible and adaptable leader to try new strategies and leadership ideologies until a best fit has been identified. Staff members at the organisation demand a more democratic structure to be motivated to commit to recurring change expectations. Now, in all instances, this is not always feasible, however my ability to utilise stronger leadership strategies will provide for trust development, openness and autonomy that is necessary to ensure motivation and compliance. If there is not some level of consensus within the organisation, democracy cannot exist. Transformational leadership and servant leadership experimentation will provide opportunities, theoretically, to enhance staff commitment and build the foundation for more shared decision-making. References Ames, D.R. and Flynn, F.J. (2007). What breaks a leader: the curvilinear relationship between assertiveness and leadership, Journal of Personality and Social Psychology, 92(2), pp.307-324. Antonakis, J., Avolio, B.J. and Sivasubramaniam, N. (2003), Context and leadership: An examination of the nine factor full-range leadership theory using the multifactor leadership questionnaire, Leadership Quarterly, 14(1), pp.261-295 Bass, B., Avolio, B., Jung, D. and Berson, Y. (2003), Predicting unit performance by assessing transformational and transactional leadership, Journal of Applied Psychology, 88(1), pp.207-217. Emery, C.R. and Barker, K.J. (2007), The effect of transactional and transformational leadership styles on the organisational commitment and job satisfaction of customer contact personnel, Journal of Organisational Culture, Communication and Conflict, 11(1), p.77. Farazmand, F.A., Green, R.D. and Miller, P. (2010). Creating lifelong learning through service learning, Business Education and Accreditation, 2(1), pp.1-14. Ford, J.D., Ford, L.W. and D’Amelio, A. (2008). Resistance to change: the rest of the story, Academy of Management Review, 33(2), pp.362-377. Grieves, J. (2010). Organisational change: themes and issues. Oxford: Oxford University Press. Grusec, J. (1992). Social learning theory and developmental psychology: the legacies of Robert Sears and Albert Bandura, Developmental Psychology, 28(5). Kim, H. and Kankanhalli, A. (2009). Investigating user resistance to information systems implementation: a status quo bias perspective, MIS Quarterly, 33(3), pp.567-582. Kouzes, J.M. and Posner, B.Z. (2012). The leadership challenge, 5th edn. Jossey Bass. Skarlicki, D.P. and Folger, R. (1997). Retaliation in the workplace: the roles of distributive, procedural and interactional justice, Journal of Applied Psychology, 82, pp.434-443. Read More