Effective Management and Leadership in Hospitals - Research Paper Example

Effective management and leadership hold a very crucial position in any business organization. The importance of management and leadership is realized by everyone and every day in our daily activities. Whether it is voting for the President of the country or choosing the Student council, both situations depict the importance of leadership and management. Management is basically defined as a group people who are united in order to achieve similar goals (Robbins & Coulter, 2001, 25). Management comprises of five main steps which are:  Planning,  Organizing,  Staffing,  Leading  Controlling It supports in attaining group objectives as it assembles the factors of production, accumulates and arranges the resources, assimilates the resources in an operational manner to accomplish aims. It leads group hard work towards accomplishment of pre-determined goals. By describing objectives of organization visibly, there would be no waste of time, effort and money. Management alters disorganized resources of human factor, machinery, money etc. into valuable enterprise. These resources are synchronized, focused and organized in such a manner that initiative work towards accomplishment of goals. Moreover, it inspires the optimal application of resources - Management employs all the physical & human resources effectively. This leads to effectiveness in management. Management allows us to achieve maximum utilization of limited resources by choosing its finest possible alternate use in business from out of a range of uses. It employs professionals and these services result in the proper use of their abilities, knowledge, and proper utilization and evade wastage. If employees and machines are manufacturing at their maximum, there will be no under employment of any resources. Management also diminishes costs as it gets maximum results through minimum input by proper planning and by using minimum input and getting maximum output. Management uses physical, financial and human resources in a manner that leads to the best combination. This aids in the reduction of costs. In addition to that, management creates rigorous organizations as there is no overlying of energies through well-defined and synchronised roles. To establish a sound organizational arrangement is one of the objectives of management which is in sync with the organizational objectives and for execution of this, it launches effective authority & responsibility. Effective management creates equilibrium as it allows the organization to endure varying environment. It stays in collaboration with this changing environment. It is also accountable for growth as well as the survival of a business (Hesketh & Laidlaw, 2010). As far as leadership is concerned, it can be categorised as one of the most significant function of management which supports to maximize efficiency and attain organizational objectives. Leadership is basically influencing the thoughts, emotions and behaviours of people. Without leadership arguments and conflicts break out. Leadership plays a crucial role in maintaining unity. However it is necessary for leaders to be visionary. Leadership is very necessary in an administering the organization. According to Steve Jobs, ‘We can’t make everybody happy. It’s beyond our capability. But we can give them the opportunity to be happy.’ Leadership is vital within an organization for the staff in a variety of ways. Firstly, leadership helps in initiating action. A leader is an entity who initiates the work by sharing the plans and policies to the juniors from where the effort actually begins (Kotter & Cohen, 2002). Motivation is also an advantage as a leader validates to be playing an incentive part in the workings of the organization. They inspire the employees with economic as well as non-economic recompenses and thereby prosper in getting the work done from the subordinates. A leader has to not only accomplish and manage but also play a managerial role for the juniors. Guidance here means training the subordinates the way they have to achieve their work successfully and competently (Wilkinson, 1988, 40). Leaders do not happen in seclusion and neither do their businesses. Leaders who are as in touch with the external environment in which their business functions, as its internal environment, and can familiarize their route to fluctuating circumstances are more likely to carry on as leaders of fruitful companies (Armstrong, 2006). Management in hospitals: Health care is a highly dynamic and changing industry. The contemporary hospital is a complicated web of associations, benefits, duties, and aims. For a hospital to function effectively, its senior managers must be proficient at harmonizing all of these parts. High-level hospital managers have always had to take care of the internal factors such as staffing, patient care as well as facilities but in recent decades with the development of the population and its amplified diversity, external factors have come to become a portion in the operations and situation of hospitals. Amongst these external factors are government regulations, policies and goals of HMOs, community relations as well as other commercial healthcare organizations (Storey, 2007). While hospital CEOs continue to be the ultimate decision makers, the chief responsibility of the CEO -- and the work that requires the highest level of expertise -- is being in agreement with and providing for the benefits of physicians, unions, patients, employees, community leaders as well as trustees. These varied interest groups often have opposing objectives, which puts burden on the effective operation of a hospital. The continuing task of hospital managers is to pilot a way through the channels of such challenging and opposing interests (Karen, 2004). As Schulz and Johnson define it, this is abled by "generating the overall culture or atmosphere of the organization, discussing and solving conflicts with major stakeholder groups and evolving the onward or strategic plan." Most hospital administrators approve that their objective is "to competently better patient consequences and community health and to deliver entrance to high quality health care for those who need it." The way, in which people collaborate with each other, with the management and with the public, indeed the degree of their obligation to their organisation, is influenced by the style of management (Kochan & Barocci, 1985). Practice shows that the bigger the organisation the more complicated it is to accomplish the essential degree of collaboration and that larger organisations are habitually much less efficient than smaller ones as people are operational against each other as a replacement for of co-operating. We will see that changing the approach of administration can in itself, increase the efficiency of operating, progress results obtained and the way in which resources are utilised, by about 20-30%. The gains to be made by improving the style of management are thus very considerable not only from the point of view of a better return to the shareholders and to the community but also from the point of view of greater contentment and satisfaction felt by employees. Managers deal with their workers in dissimilar ways. Some are stringent with their staff and like to be in absolute control, whilst others are calmer and allow employees the self-determination to run their own functioning lives. Whatever approach is predominately used it will be fundamental to the accomplishment of the business. “An organization is only as brilliant as the individuals operating it” (Delery & Doty, 1996, 802). There are three most important categories of leadership styles: autocratic, paternalistic and democratic. Autocratic (or authoritarian) managers like to make all the vital decisions and personally administer and organize workforce. Managers do not generally have faith in the employees obey all the orders that are given to them. This approach derives from the views of Taylor as to how to encourage employees and relates to McGregor’s theory X view of employees. This approach has restrictions (as highlighted by other motivational theorists such as Mayo and Herzberg) but it can be successful in certain situations. Like when quick decisions are wanted in a company (e.g. in a time of an emergency), or when controlling large numbers of low skilled workers (Pfeffer, 1994). Paternalistic managers give more interest to the social needs and views of their personnel. Managers are concerned with how happy employees feel and in a lot of ways they operate as a father figure (pater means father in Latin). They seek advice from workers over issues and pay attention to their advice or opinions. The manager will nonetheless make the actual decisions (in the best wellbeing of the employees) as they consider the staff still needs direction and in this way it is still to some extent an autocratic approach. The style is strongly related with Mayo’s Human Relation view of motivation and also the social needs of Maslow (Clutterbuck, 2004). A democratic style of management will put faith in workforce and support them to make decisions. They will entrust to them the authority to do this (empowerment) and pay attention to their suggestions. This requires good communication and frequently involves democratic discussion groups, which can offer constructive proposals and ideas. Managers must be prepared to encourage leadership skills in subordinates (Bradshaw, 2001). The definitive democratic structure occurs when decisions are made based on the majority view of all employees. Nevertheless, this is not possible for the bulk of decisions taken by a business, indeed one of the criticisms of this style is that it can take more time to reach a decision. This style has close relations with Herzberg’s motivators and Maslow’s higher order skills and this can also be applied to McGregor’s theory Y view of workers (Becker & Gerheart, 1996, 779). Mentorship provides a distinctive chance for healthcare staff to inspire the next generation of professionals and eventually the expansion and development of their particular profession. Mentor preparation training programmes, and the succeeding yearly mentor updates that are mandatory by the Nursing and Midwifery Council (NMC) (2008a) assist mentors to gain a consciousness of the position and to preserve prevalence of their knowledge. Therefore, the attention of mentorship lies with the prospects that the part includes and the considerate that the mentor needs to witness mentorship. One of the most credited accountabilities of mentors, regardless of detailed profession, is their skill to assist knowledge for health-care students from both standpoints – the mentor as well as the student. The health care system is very intricate. Its structure differs from most of the businesses in which the consumers come unwillingly. When the bills fail to get paid it damages the state of the cash flows, hence this business is usually classified as a shaky business. Health care management problems aren't always easy to fix because of the uncertain revenue, costs not entirely within their control, and regulatory issues, 1. Defining Revenue It's difficult for health care bodies to constantly define their revenue. Most organizations can set a sales goal and then make its people try to achieve that goal. In health care, the profit goals depend upon the health and well-being of the population. Hospitals market services which they hope physicians will use if their patients require those services. But when there is more than one hospital, physicians have privileges at one hospital only, which means their patients will be going to the hospitals where they have those privileges. Health care entities don't get paid what they charge. Every insurer gets a concession, and these days even self-pay patients get concessions off their invoices. This means that just marking up bills won't have an effect on cash all that much, but can give hospitals a false sense of how gainful they may or may not be. 2. Controlling Costs Health care associations have worked for years to try to limit their costs. But there are only so many costs they can limit. State regulations mandate how many of certain types of personnel must be there for special medical procedures or medical care, including the obligation for individual physician offices to have nurses if they care for patients of the opposite sex. It also legalizes how many hours some of this staff is allowed to work repeatedly (Paauwe, 2009, 46). Some procedures are permitted in explicit areas also, which means those areas must be taken care of even if they're not used regularly. And, because many management staff is trained only in their particular area of expertise, they are less than competent when it comes to understanding how to budget and limit costs within their own departments (Allen, 2010, 209). 3. Training and Certification Trained professionals must prove they're making an effort to maintain constant education, and that comes at a price to medical facilities. Certified professionals are required to study a definite number of hours per year to keep those certifications up to date for various areas of medicine, at many stages. Inside hospitals, there are also requires to have different varieties of training, such as that assigned by the Occupational Health and Safety Administration. It is also vital to uphold certifications of quality standards, especially that from the Joint Commission (Ballan, Smith & Lorentzon, 2008, 575). Leadership In medical facilities, there's usually a single leadership spot in each specialty. Most of the time, the person venturing into management possesses technical skills, but not necessarily leadership abilities. Because of scarcity of staff, preparation problems and monetary reflection, leadership training isn't a high concern for these businesses. Therefore, there's a shortage of true leadership and high-quality management, which means many staff have to depend on learned abilities rather than direction provided by mentors (Ulrich, 1996). Nurse educators pool clinical expertise and a desire for teaching into rich and satisfying careers. These specialists, who make effort in the classroom and the practice background, are accountable for formulating and guiding current and future generations of nurses. Nurse educators are an essential part in consolidation of the nursing workforce, helping as role models and giving the leadership wanted to tool evidence-based practice (Prahalad & Hamel, 1990). REFLECTION: Staff nurse’s negative attitude towards dyslexia is not uncommon and there is still some evidence of disability discrimination towards student nurses; this could be due to ignorance by nursing staff who know little or nothing about dyslexia (Tee et al, 2010). I have experienced negative attitudes to my learning difficulties from some health professionals, which undermined my confidence. Godwin and Thomson (2004) state all students will have strengths and weaknesses regardless of whether they have a disability or not, by effectively managing their weaker areas they can demonstrate effective team working. Students with impairment will also bring extra skills to the placement, as is the case with the student with the hearing impairment being able to lip-read and as such finding it easier to communicate with patients who have speech difficulties or have a tracheotomy tube in their windpipe (Strategies for Creating Inclusive Programmes of Study, 2010). The Equality Act 2010 brought about legislative changes to prevent discrimination in educational settings, which could result in the numbers of students with impairments within the National Health Service increasing. Mentors will have to enhance their understanding of the special learning needs of their mentee, and implement and adjust accordingly to these needs within clinical practice. The Department of Health (2004) and Tee et al (2010) highlighted that, on some occasions students still received inadequate support to develop and enhance their competences. There are of course many different types of impairment that challenge a student mentor relationship. Adjustments which will be made to enable a student with impairment to acquire new skills and proficiency will often be determined by either the Occupational Health Department within the trust, the Local Educational Authority or the Disability Student Support Services within the Higher Education Institutions, although most can be overcome with simple and obvious steps designed to improve and help the student. On a recent placement there was a student with a hearing impairment, the sister discussed asked what adjustments would help to make things easier, small but significant changes, such as reducing background noise as much as possible, taking steps to ensure staff talked face-to-face and stayed in close proximity were introduced. This helped both student and mentor to achieve a satisfactory learning experience and I felt they provided a good example of a skilful and experienced leader. Facilitating learning starts on the first meeting and is one of the eight domains of mentorship. The FAIR principle of learning includes Feedback Activity Individual Relevance and is a useful tool for mentors (Hesketh and Laidlaw, 2010). Lloyd-Jones et al (2001) states that feedback is vital and it should be constructive and given frequently. I feel that it helps both my mentor and I to identify areas that need building upon, also discussing areas in which I had improved. Lloyd- Jones et al (2001) say that feedback is also important for maintaining motivation, I agree with this as it gave me the opportunity to discuss any concerns I had, making me feel valued as my mentor listened to me as an individual. I was given the opportunity to be involved in my own learning which enabled me to have a clearer insight on what was expected from me. Feedback also helped me to be clear about what I wanted from my mentor, from my placement and how to make the appropriate changes. Mentors need to use their knowledge of the student’s stage of learning to select appropriate learning opportunities, and to promote the facilitation of learning it is helpful for mentors to understand a student’s learning styles. Flemings (2001) explained that learners have a preference for learning through visual (seeing), aural (hearing) or kinaesthetic (doing) (VAK). Honey and Mumford (1992) said that students often combine styles, and I agree with this as I myself need to see and do in order to understand the lesson or procedure and therefore combine visual and kinaesthetic styles. I feel that by knowing a student’s learning style and what knowledge they have gained from previous placements the mentor can then tailor learning to suit the individual student. Frankel (2009) states that nurse mentors should be prepared to be adaptable to the preferred learning methods of their student in order for teaching to be productive and I feel mentors who take the time to adapt to their students particular learning style enhance their relationship. I felt more confident in disclosing my impairment to my mentors, so that they could then tailor their teaching method to suit. My mentors were then able to find out my coping strategies as well as whom they could contact if they needed further advice, our university provides contact numbers and offers sessions for staff to increase their knowledge of learning impairments. My impairment is dyslexia and it affects me in the speed in which I process information and I find note taking difficult because I am unable to write quickly and listen at the same time which is made more difficult when spelling unfamiliar words. I also lack confidence when speaking in front of others and as my mentor was aware of these problems we would go over handover together to make sure I had all the information needed with my mentor then allowing me to finish without interruption before adding her own input, which helped to build my confidence. The RCN (2007b) published a report giving guidance to mentors concerning dyslexia in which they say that a student should be allowed to use a calculator when performing drug calculations, student must however be able to demonstrate their knowledge of drug calculations. To help with my numeracy and to see if I knew how to work out a calculation, my mentor would set a few drug calculations for us to go over during feedback but I would use a calculator during medication rounds as I would become flustered and panic if I felt I was taking too long; leading to me potentially making mistakes and as previously mentioned the primary responsibility of the mentor is to the patient. Mentors assess students in three ways continuously, formatively through structured learning; this was done by my mentor during feedback, and summative which comes at the end of the placement by signing student’s outcomes. Mentor and student are accountable, when delegating a task the mentor should know if the student is competent, this can be done through assessment, equally the student is accountable for their actions having been delegated a task if they are not sure about their competency they should inform their mentor. I was asked to redress a patients leg wound, as I had not done a wound dressing for a while I asked my mentor if she would assess me first. Once completed, my mentor said she would be happy for me to do the task unsupervised the next time. Both Mentors and sign off mentors must fail the student if they have not met the standards of proficiency in practice and are not capable of safe and effective practice (The NMC 2008). However, the student should have been given assistance to develop an action plan with a review date in order to achieve before it reached the failed stage (Siviter 2008). The University of Hertfordshire followed up the research by Duffy (2004), their unpublished findings found that seven years on mentors were still reluctant to fail their students (Gainsbury 2010). When I asked my mentor how she felt about this statement, she said that any concerns would have been resolved before it came to signing off my competencies, but had they not been resolved she would not hesitate to fail me, as she is accountable in confirming my ability to practice as a nurse. My mentor also said that I should see dyslexia as a positive not a negative and when I asked her about this, she said I was aware of my strengths and weaknesses and would be more Hence, it is crucial to realize that the negative attitude towards dyslexia is not uncommon and there is still some evidence of disability discrimination towards student nurses; this could be due to ignorance by nursing staff who know little or nothing about dyslexia. All students will have strengths and weaknesses regardless of whether they have a disability or not, by effectively managing their weaker areas they can demonstrate effective team working. Students with impairment will also bring extra skills to the placement, as is the case with the student with the hearing impairment being able to lip-read and as such finding it easier to communicate with patients who have speech difficulties or have a tracheotomy tube in their windpipe. Therefore, a disability can also present itself as a blessing in disguise at times. It is important to realize that disabilities are common but they can also be used to our advantage if taken positively. REFERENCES: Lisa Eckelbecke. (2005). High on the hog. In: WORCESTER, MASSTELEGRAM & GAZETTE. London: Franklin St. 1 Robbins and Coulter (2001). Management. 9th ed. London: Prentice Hall. 25-142 Hesketh, E. A. & Laidlaw, J. M. (2010). Facilitating Learning Kotter, J. P. & Cohen, D. S. (2002). The Heart of Change. Boston: Harvard Business School Publishing. Armstrong, Michael (2006). A Handbook of Human Resource Management Practice (10th ed.). London: Kogan Page. ISBN 0-7494-4631-5. OCLC 62282248 Storey, J. (2007) "What is strategic HRM?" in Storey, J. (2007) Human Resource Management: A Critical Text, Thompson Pfeffer, J. (1994) Competitive advantage through people, Harvard Business School Press Becker, B. and Gerhart, B. 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