Contemporary Issues in Health Care Leadership - Article Example

Running Head: Journal Article Student’s Name: Instructor’s Name: Course Code and Name: University: Date Assignment is due: Health Care Leadership Roles –Journal Article Abstract This article modifies the traditional functional leadership model to accommodate contemporary needs in health care leadership based on two findings. First, the article argues that it is important that the ideal health care leadership emphasize the outcomes of the patient care more than processes and structures used to deliver such care and secondly, that the leadership must strive to attain effectiveness of their care provision and note merely targeting the attractive option of efficient operations. Based on these premises, the paper reviews the traditional Functional Leadership Model and the three elements that define the type of leadership an organization has namely, the tasks, the individuals, and the team. The article argues that concentrating on any one of these elements is not ideal it is necessary to add a new element to the model to construct a novel Functional Result-Oriented health care leadership model. The recommended Functional-Results Oriented leadership model embosses the results element on top of the other three elements. Such that every effort on health care leadership is directed towards attaining excellent patient outcomes. The Functional Results-Oriented model is supremely applicable in governmental establishments since it uses the staff talents (individual), their teamwork potential (team) and the mission or mandate of the institutions such as delivering effective and efficient health care (tasks) in a balanced way and all targeted at achieving excellent patient outcomes (Results). Introduction Following a very successful leadership clinic for health care organizations in my hospital, several issues were fronted as pertinent to the contemporary health care leadership practice. Most importantly, the leadership clinic focused on the dynamics of starting new leadership programs or modifying the existing programs within health care setups as a means of promoting efficiency and effectiveness of health care provision. This article, postulates a novel model of health care leadership applicable in for-profit, not-for profit and or government health care organizations. To begin with, the article introduces contemporary issues in health care leadership, before recommending a single model that can help for-profit, not-for profit and or government health care organizations promote the efficiency and effectiveness of their health care provision. The paper then proceeds to present the constructs of the recommended model of leadership with clear and detailed diagrams as well as explanations. To validate and justify the recommended model of leadership, the paper will also present a detailed analysis of how the model is relevant to the contemporary health care leadership practice. Finally, the article will terminate with a viable conclusion on the issues raised throughout the discussion. Contemporary Issues in Health Care Leadership One of the dominating issue in contemporary health care leadership practice is whether the leaders should prioritize the processes of delivering care, the structural framework of their healthcare institutions or the outcomes of their health care programs, when striving for more efficient and effective care provision (Jasper & Jumaa, 2005; Shortell, 2006). Rubin, Pronovost and Diette (2001) in Shortell (2006) posts that, health care can be measured by studying the processes, structure and outcomes of healthcare programs and organizations. Arguably, the most important of the three – structure, process and outcomes – in health care quality management is and should be the care outcomes. A good structure that does not achieve the objectives of a healthcare institution or program is worthless and much more of a waste of public resources or private investment (Gilmer, 2005). Similarly, effective bureaucratic processes that still do not help patients in their needs, are as worthless (Gilmer, 2005). When patients get quality outcomes from medical care, the objective of the health care institution or program are attained (American Hospital Association, 2010). As such, health care leaders have their primary mandate as serving the interests of the patients by providing excellent care outcomes (Pelote, Pelote & Route, 2007). Their performance is only judged from the outcome of their administration since very few patients will want to know how things run (processes) or who is senior or answerable to whom, in a hospital (structure) (Galbraith, 2001). Ideally, both processes and structures are measures adopted to improve the outcomes (Jasper and Jumaa, 2005). How good the processes are and how good the structures are can and should only be evaluated based on the outcomes. In healthcare leadership, the leaders must be adept at working the structures and processes of health care provision until they are able to facilitate efficient and effective care, thus generating excellent care outcomes (Shortell, 2006; Galbraith, 2001). The leadership model instituted in a health care facility, be it a not-for-profit, fro-profit or governmental organization, must focus primarily on initiating, adjusting, improving and constantly review the structures and processes of care provision as a means of amplifying the patient outcomes (Pelote, Pelote & Route, 2007; Gilmer, 2005). Further, contemporary leadership practices in health care provision tend to emphasize on effective care more than the efficient with which such care is provided (Shortell, 2006). For instance, a not-for-profit hospital with limited number of staff and operating in a poor community without another hospital nearby may believe in giving quality care to their patients. Yet, while they may provide effective care to a few patients, they will be unable to cater for the high demand for medical care services in the area. In this regard, they will be offering efficient care ineffectively. The fact that health care is evaluated based on what it achieves and now how it achieves it makes efficiency by itself unsatisfactory (Jasper & Jumaa, 2005; Galbraith, 2001). On the other hand, it is impossible to provide effective care inefficiently (Gilmer, 2005). Lack of efficient leadership means that nothing will get done or done well. It is impossible to provide effective care inefficiently since if the systems and the practitioners are inefficient, the healthcare provided cannot be effective (Gilmer, 2005). Patient records will be lost, departments in their respective fields will not collaborate to help patients, there will be no sense of responsibility or accountability, duplicate and inconsistent efforts will mean much effort is put in producing little results etc. All these are symptoms of inefficiency, which will mean that the patients will not be given efficient care (Gilmer, 2005; Jaffe, 2009). The analysis provided above helps project two very important points relevant to any consideration of an ideal leadership model for a health care institution. First, it is important that the ideal health care leadership emphasize the outcomes of the patient care more that the processes and structures used to deliver such care and secondly, that the leadership must strive to attain effectiveness of their care provision and not merely targeting the attractive option of efficient operations (Shortell, 2006). The Leadership Model Recommended Based on the analysis provided above, this article seeks to propose a Functional Results-Oriented Leadership Model, which is a modification of the traditional functional leadership model. First, the article will provide a brief introduction of the traditional functional leadership model. This model was based on John Adair's Three Circles leadership model postulated in the late 1950’s (Gardner, 1956). The model conceives of the role of leadership as a desirable set of behaviors, which helps a particular group within a singular setting to perform their tasks and reach their group goals. Leadership is not conceived as a person-specific but as traits attributable to an organization or team and which help them to effectively achieve their organization/team goals effectively (Gardner, 1956). The model postulates that, a leadership function must necessarily meet the needs of three areas namely, the predefined task, the team and the individuals forming the team (Gardner, 1956). The relationship between these three areas is in a union as indicated by the following Venn diagram. This model has been used with great success in the British and Canadian military. It has however come under great criticism by later theorists who claim that it is an over simplification of a very complex role, leadership (Northouse, 2006). According to the theory, leadership behaviors should be divided into three distinct types based on which of the above three areas they prioritize (Northouse, 2006). The first type of behavior is substantive, which refers to behaviors that are only directly relevant to getting the organization’s tasks done (Northouse, 2006). It prioritizes the task more than either the team of the individuals (Northouse, 2006). Leaders who prioritize substantive behaviours are always proposing workable solutions and or providing crucial information to solve the challenges that lie between the staff and high performance (Northouse, 2006). The following Venn diagram can represent this scenario or type of leadership. The second type of leadership behavior focuses more on the group/team than either the task or the individuals (Northouse, 2006). This type of leadership is called procedural leadership, since its typical behaviors are those that seek to establish beneficial team playing, team exchange, and team participation. It regards every decision from a group perspective, by developing particular group procedures that helps the team members to work together (Northouse, 2006). The test of good leadership here becomes the level of agreement and relationship among the organization/team members (Northouse, 2006). The following Venn diagram illustrates this type of behavior. The third type of leadership according to the functional leadership model is maintenance leadership whose typical behaviors tend to prioritize the individual employee or staff member over both the team in which he or she works or the tasks he or she is assigned (Northouse, 2006). This type of behavior always strives to improve the individual participation, satisfaction and achievement (Northouse, 2006). In a group setting for instance, a maintenance leader will always encourage the silent and shy members to join a discussion. Such leaders tend to satisfy employees first as a way of boosting their performance in developing their skills, giving satisfactory compensation, offering good benefits, counseling etc (Northouse, 2006). The following Venn diagram illustrates this type of behavior. The Functional Results-Oriented leadership model proposed by this article introduces a fourth element that is very crucial in health care provision (Pelote, Pelote & Route, 2007). In this model, results become the center circle embossed on the three other circles of tasks, individuals and teams. Constructs of the Functional Results-Oriented Health Care Leadership Model The Functional Results-Oriented leadership model is perfectly fitting to a governmental health care organization, one tailor-made to meet the needs and challenges of effective and efficient health care provision. The reasoning is simple. If health care leaders concentrate on the individual staff, they will forget the patient who is primarily the single most important person to any health care program. Again, it is not guaranteed that when individual health care providers are tended to excellently, they will provide effective and efficient care. Nonetheless, while not being the priority, individual attention is necessarily since without motivation, every other strategy in health care provision will fail (Shortell, 2006). The task by itself cannot be the focus of health care leadership. To begin with, when a doctor sees a patient and recommends treatment, his or her task is not yet done. The task only gets done when such a patient recovers from the illnesses, succeeds in preventing a disease or is helped to manage the medical condition diagnosed (Almgren, 2007). This brings in many people starting with administrative staff, support staff, nurses, clinicians, laboratory technicians etc. by the time a single patient is served fully in a government health care establishment for instance, she passes along the hands of many professionals (Shortell, 2006). That means that a single patient is a task to far too many people, each of whom contributes to the patient outcomes (Shortell, 2006). Finally, health care leadership cannot solely concentrate on the team since good and efficient teamwork as discussed in the introductory sections of the article is not an adequate indicator of excellent health care provision (Jaffe, 2009). A team can work very well and still be ineffective. Effectiveness in health care as already discussed must always be prioritized over efficient team work and care processes (Pelote, Pelote & Route, 2007). This introduces a fourth element that was not conceived by the earlier functional leadership model, one that is of utmost importance on health care. The fourth element is results (patient outcomes). The introductory argument helped illustrate how the patient outcomes are the only indicator of good health care leadership, since they constitute the primary mandate of every health care establishment (Shortell, 2006). No matter how perfect the health care team is, no matter how motivated the care staff is, no matter how well the care procedures are articulated and practiced, the yardstick of good health care leadership is patient outcomes, the results of care (Jaffe, 2009). The following diagram (not Venn) illustrates how the Functional Results-Oriented leadership model can work. Relevance of the Functional Results-Oriented Health Care Leadership Model The reason why this model of leadership was preferred for this article is because it fits perfectly the health care organization setting, be it for-profit, not-for-profit or governmental. For instance, any medical staff irrespective of the discipline and specialization (of which they are hundreds in any one hospital) can qualify for a leadership position without necessarily imposing other requirements (Pelote, Pelote & Route, 2007). There are very good leaders who are nurses, others are surgeons, others are laboratory technicians, others are obstetricians and others still, are general practitioners (Almgren, 2007). Health care leaders must be handpicked based on their abilities, their personal traits, their credibility, or their potential and not based on which area of health care provision they are qualified to work in (Almgren, 2007). The Functional Results-Oriented leadership model emphasizes on the process (how) that an organization uses in its leadership rather than the individual entrusted to lead (who). It is not about the person assigned the leadership role but the particular role he or she is assigned and his or her ability to deliver results in that role. Instead of spending time, effort and a lot of resources looking for an ideal leader (individual), this model primarily requires that the health care establishment spend the effort and resources in developing the leadership role that will allow for effective and efficient carte provision before identifying the person who can adequately fit that role (Shortell, 2006). The conglomeration of the three types of leadership behavior as posted by the functional leadership model into a singular behavior that uses the team, tasks and individuals to work towards desired results enables any health care professional member to perform effectively in leadership (Pelote, Pelote & Route, 2007). Again, as posted in the foregoing section analysis, health care provision must be geared towards getting desired patient outcomes and not the processes of care of the organization structures of a health care facility (Almgren, 2007). This model emphasizes on results, where teams are assigned tasks and individuals are held accountable for their contribution or lack of, to the team’s attainment. Results take center stage in this model. This model is applicable in any size and type of health care organization, but particularly for large governmental health care organizations. As Shortell (2006) notes, health care facilities from governmental, for-profit or not-for-profit, require a similar management structure but for their operating principles. While the aspirations and targets may differ, the mandate remains centered on patient care. The greatest advantage of this health care leadership model is that, it uses the staff talents (individual), their teamwork potential (team) and the mission or mandate of the institutions such as delivering effective and efficient health care (tasks) in a balanced way and all targeted at achieving excellent patient outcomes (Results). As such, the leaders consider individual motivation factors (individuals) with the primary goals of ensuring good results, they deliberate on ideal teamwork procedures and communication channels (team) again with the primary goals of ensuring good results and finally, they assign protocols on care provision in terms of correct procedures and processes (tasks) the primary goals of ensuring good results. Everything is easily configured towards one ultimate objective, that of achieving excellent patient outcomes. Conclusion This article begun by initiating a discussion on contemporary issues in health care from which an ideal health care leadership should be reviewed. In this introductory analysis, the article projected two very important points relevant to any consideration of an ideal leadership model for a health care institution. First, the article argued that it is important that the ideal health care leadership emphasize on the outcomes of the patient care more that the processes and structures used to deliver such care and secondly, that the leadership must strive to attain effectiveness of their care provision and note merely targeting the attractive option of efficient operations. Based on this analysis, the paper reviewed the traditional Functional Leadership Model as postulated by John Adair's Three Circles leadership. The paper helped discuss the three elements central to this traditional leadership model namely, the tasks, the individuals and the team. After a discussion of each, the paper arrived on the three types of leaders as determined by which of the three elements they prioritized most. According to the analysis, it emerged that we have three types of leadership (conceived from the traditional functional leadership model) namely the substantive (task-based), procedural (team-based) and maintenance (individual-based) types of leadership. The paper proceeded to argue that concentrating on any one of these elements is not ideal since good tasks, procedures; processes and teamwork only attain efficiency, which is of secondary value in health care. The primary role of a health care establishment as the paper argued is patient outcomes (results of the care). It therefore became necessary to add a new element to the traditional functional leadership model namely, results, which is an element that is of utmost importance to health care leadership. Due to this significance of results in health care, the recommended novel health care leadership model, the Functional Results-Oriented leadership model embossed the results element on top of the other three elements. As such, tasks, individuals and teams become the foundation on which results are generated. The paper argues that in this model, every effort is directed towards attaining excellent patient outcomes. The Functional Results-Oriented model is supremely applicable in health care organizations, more so in governmental establishments. Its greatest advantage is that, it uses the staff talents (individual), their teamwork potential (team) and the mission or mandate of the institutions such as delivering effective and efficient health care (tasks) in a balanced way and all targeted at achieving excellent patient outcomes (Results). References Almgren, G. (2007). Health care politics, policy, and services: a social justice analysis. New York: Springer Publishing Company. American Hospital Association (2010). “Fast Facts on U.S. Hospitals from AHA Hospital Statistics”. Hospital Connect. 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