Management vs Leadership in Medical Organization - Essay Example

Running Head: LEADERSHIP AND MANAGEMENT ISSUES Leadership And Management Issues [The [The of the Leadership And Management Issues Introduction According to the experts the definition of leadership that would be extensively accepted by the preponderance of theorists and researchers might say that "leadership is a procedure of social influence in which one person is able to enlist the aid and support of others in the achievement of a common task." (Adams J. S. 2003, 422-436) The major points of this definition are that leadership is a group activity, is based on social influence, and revolves around a common task. Although this specification seems relatively simple, the reality of leadership is very complex. Intrapersonal factors (i.e., thoughts and emotions) interact with interpersonal processes (i.e., attraction, communication, influence) to have effects on a dynamic external environment. Each of these aspects brings complexity to the leadership process. It is the purpose of this book to try to make that complexity a bit more manageable, thus increasing our ability to understand what effective leadership is (Anderson L. R. 2004, 85-96). The reform of the American health care system going on now at a thoughtlessly rapid pace is approaching primary care into importance in managed care organizations all through the country, with it seems that little understanding of what primary care medicine be supposed to be. In the worried modern medical world, it is little noticed that throughout its rise to prominence the idea of primary care has been altering from largely an organizational concept connected to the pecking order of services in medical care to a sophisticated generalism. The pressure for its new form comes from rising costs and current difficulties in health care delivery and subspecialty medicine. The emergence of the new generalism is also propelled by the mismatch between the high-technology medicine at which we excel and the health care needs of large groups of the population for example, the poor, chronically ill, aged, and disabled. A shortage of physicians in rural and other underserved areas is also an impetus for finding ways of introducing more primary care physicians into these settings. Management Issues in Health Organization for Leader Hospital based care is becoming gradually more acute and multifaceted, and recent documents reviewing adult dangerous care services have defined the need to offer critical care without walls (DoH, 2000). One way in which consultant nurses in dangerous care are responding to these altering healthcare needs and government policies is throughout the growth of critical care outreach teams (Tume and Bullock, 2002). These were developed in response to research which demonstrate higher mortality rates for ICU patients admitted from ward areas compared by means of those confess from theatre or accident and crisis. This was believed to be due, in part, to delays in be familiar with patient deterioration and sub best treatment (Singer and Little, 1999). One two centered study recognized that up to 41% of ward patients were transferred to critical care too late to considerably get better patient outcome (McQuillan et al, 1998). When considering these findings it is obvious how growth of an outreach service could directly and considerably impact on patient care. Management vs. Leadership in Medical Organization for Devices Differences. No doubt, leadership is one of the a lot of assets a nurses can possess. Care must be taken in unique these two theories. The main goal of a manager is to capitalize on the production inside an organization from side to side executive decisions to take care of medical equipments or operation devices. To reach these decisions nurses and health supervisors must make use of the 4 functions of medical device care in hospitals; planning, manage, recruitment, directing and controlling. No doubt, leadership is just one significant component of the straight function to observe the equipment care. A manager/nurse cannot just be a leader he also has to also have the formal power to be effective. Managers/nurses believe incrementally, while leaders believe fundamentally. Moreover, managers do things by the book, and go after company rule while leaders follow their own insight, which in lots of cases is more helpful to the hospitals. A leader is also more moving and creates a connection with the hospital staff, where as the manager/nurses is more strong (Ashour A. S. 2003, 339-355). Historical Development Of Leadership Theory in Medical I have, thus far, drawn leadership in broad brush strokes, and it would be useful to move to a level of greater specificity. To ask the question, "Exactly what should leaders do to be effective?" Over the course of history and across the sweep of cultures, a good deal has been written about effective leadership. In our own era, writings about leadership have become quite popular. We turn now to see what insights can be gleaned from those sources (Avolio B. J., 2000). Primary care medicine is based on the centrality of the patient rather than on an organ system or a disease, as is the case with specialism. It is addressed to both the sick and the well. It understands functional impairment and disease to be processes that enter into the patients life story, so that its interventions are chosen with the development of that story in mind. Because of this, it is as well suited to prevention as to treatment, to children as to adults, and especially to the care of the chronically ill, who make up the largest number of the sick in our society. Primary care medicine can best be provided by generalists who are specifically trained to meet the broad, as well as the intellectually and technically exacting, demands implied in the definition of the term. These are doctors who are able to come to know the sick or well person and join this information with their knowledge of medical science, disease, and technology in the diagnostic, therapeutic, and preventive processes. So, generalism and generalist are terms that have come into use, in part, to counter the simplistic ideas often associated with the term primary care. Research And Theory To Solving Problems of Device Care If we analyzed then we come to know that the failed medical programs of the 1960s have to be kept in mind for the lesson they teach. Approximately all the evocative ideas and terms currently used to imagine the advantages of primary care for instance, continuing, organize, complete, treating the entire person typify the medical programs finance as part of President Lyndon Johnsons War on scarcity. Obviously sufficient, as the money dried up, the programs and the medical care organization that were part of them departed (by means of the exemption of todays group of people health centers, the grandchildren of the area health center). The ideas ,unfortunately ,also wasted, suffering from hunger (Bandura A. 2002, 122-147). They did not catch on or become institutionalized because, without medical knowledge and skills to match the rhetoric, they were blown away by the fresh winds of specialty medicine and burgeoning technology. Throughout the same period, a lot of medical schools had communal and behavioral science agenda that also usually failed to interpret their teaching into medical do, and they too gray (Bandura A. 2006). The family physician group grew fast in the early years following its bureaucrat title as a specialty in 1970 but then hesitate, its enlargement slowing until its new marked renaissance. Palliative care carries on moving violently to gain receipt inside mainstream medicine, though the number of hospices in the United States carry on rising (Barnard C. I. 2005). Throughout these years, in spite of the difficulty of receipt and well before the modern administer care explosion, the medical literature reflect an increasingly growing interest in generalism. In light of the notice given to the subject and its significance, though, what has been written regarding primary care medicine is unsatisfactory because it is incomplete (Bandura A., & Cervone D. 2003, 1017-1028). No doubt, teaching in regard to medical science and skill has far outpaced that of the art. The preparation of primary care physicians have to recognize a distinction flanked by doctoring itself and the medical science on which it is bottom. If primary care physicians are to complete their predictable role, teaching the method and information base of doctoring as well as how to be a doctor be supposed to be as open as lessons medical science. A true and continued shift toward the teaching of primary care physicians, consequently, will rely on separate changes at all levels of medical teaching. The main beliefs are clear sufficient; there have been adequate classes that offer examples or yet role models; what is wanted now are knowledge-based skill. For instance, properly taught message skills based on information of how the spoken language works and a sympathetic of the nature of relations will bear inside physicians who practice long after the facts of medical science erudite in medical school has turn into out of date. Critical Incident With Thoughtful Analysis According to the expert analysis, technological transform and financial pressure are moving medical put into practice out of hospitals and into the residence or additional choice health care location. Patients with constant situation may be capable to move out of the hospital by using mixture devices that hold up self-administration of drugs. For instance, diabetics may use these mixture devices for insulin therapy, and females through high-risk pregnancies may use these devices to self-administer drugs that manage preterm work (Broome, A. 1998) . If we analyzed then we come to know that these alterations are made probable by changes in medical knowledge automatic mixture devices. Though, if these new computer-based devices are intended badly from a user-centered point of view, they can persuade mistaken actions. Previous studies of computer-based medical devices in dangerous care medicine have found that computer-based medical devices frequently show a diversity of typical human-computer interaction (HCI) shortage, such as poor criticism about device state and performance; complex and vague sequences of process; multiple, poorly illustrious modes; and vague alarms. These shortages are significant since they have been exposed to add to the potential for mistaken actions and to damage the physicians aptitude to detect and get well from errors (Goleman, D. 1996). In this research we make bigger the outcome of those studies of medical doctor interaction by means of computer-based medical devices to the home health care background. We look at how nurses and patient-operators interrelate with a computer-based combination device used for terbutaline infusion to extravagance preterm labor in women knowledge high-risk pregnancies. This device was at first used in insulin management for diabetics, but it was modified to assist in the control of preterm work (Department of health 2003). Leadership Theories We can credit path-goal theory for awakening leadership researchers to the moderating role of environmental factors on the relationship between leaders and followers. Some other interesting theoretical ideas have evolved from this approach. Kerr and Jermier ( 1978) developed the "substitutes for leadership" concept. In the tradition of path-goal theory, Kerr and Jermier argued that the leaders function is complementary, that is, to provide for subordinates direction or support that is missing in the environment (e.g., structure for an ambiguous task). If the environment already supplies that resource, the leaders behavior becomes unnecessary and will have little effect on subordinate reactions. For example, explicit job descriptions or comprehensive training could reduce the value of the leaders structuring behavior for clarifying the subordinates task. Similarly, supportive and closely knit work groups might substitute for the positive emotional effects of a supervisors consideration. Also, features of the situation can have the effect of neutralizing any impact that the leader might have. For example, rigid organizational policies or technology-determined work patterns could render ineffectual any attempts at leadership influence (Bales R. F., 2001, 485-495). Many path-goal theory studies addressed the degree of ambiguity in the subordinates job, operationalized either by subordinate ratings of task structure ( Downey, Sheridan, & Slocum, 1975, 1976; Stinson & Johnson, 1975), by role ambiguity ( Dessler & Valenzi, 1977; Valenzi & Dessler, 1978), or by task variety ( Schriesheim & DeNisi, 1981). Other studies have inferred the degree of role ambiguity from formal structural variables such as administrative level ( Sims & Szilagyi, 1975a, 1975b), group size ( Schriesheim & Murphy, 1976), and organizational size ( Miles & Petty, 1977). Strategic Leadership These types of issues are so far-reaching that many would see traditional leadership approaches, based on face-to-face interactions at lower organizational levels, as being of little use or even irrelevant. How important can a first-level supervisors consideration or initiating structure be when Xerox has restructured to the point where direct labor accounts for barely 10 percent of total cost? How important can such leadership be when productivity increases have come from drastic cuts in the size of steel-making crews to deal with worldwide competition? These kinds of questions, especially when combined with the earlier views of those who have argued that leadership doesnt matter, might suggest the demise of leadership as a serious topic of study (Semler, R. 2004). The key aspect that sets off the study of strategic leadership from the traditional leadership approaches mentioned earlier is its emphasis on those individuals or teams with the overall responsibility for the organization. The traditional leadership approaches, emphasizing lower-level, face-to-face influence, comprise more than 90 percent of the leadership literature (Semler, R. 2001). Models such as those proposed by Hambrick ( 1989), Hambrick and Brandon ( 1988), and Jackofsky and Slocum ( 1988) and one discussed by Hunt and Blair ( 1985), based on earlier work by Hunt, Osborn, and Martin ( 1981) and Hunt and Osborn ( 1982), are consistent with this strategic leadership emphasis. Hambricks model illustrates the essence of these approaches. It considers important strategic elements (settings, organizational form and conduct, and organizational effectiveness) and representative connections among them (e.g., settings influencing strategic leadership, strategic leadership affecting organizational form and conduct) (Bartol K. M. 2004, 225-233). Private Sector And Public Sector Organisations Functions The reason of the study was to examine how nurses and patient-operators used the device to control preterm work and to recognize individuality of the device that make its operation hard and prone to mistake. Many researchers also paying attention on how the perinatal nurses urbanized strategies to work approximately or guard next to the HCI deficiencies in the device (Cook & Woods, 1996). These version or dressmaking strategy occurred since patients and their nurse caregivers were in accuse for attain their own goal: for the patient to stay at home throughout a hard pregnancy and to have a winning delivery as close to term as likely, regardless of the plan of the computer-based device. Three kinds of investigations were carried out: (a) meeting by means of nurses concerning how they used the device and concerning how patient-operators used the device; (b) "bench" tests that travel around how the device perform, how the displays stand for those states and behavior, and the control sequences wanted to interact by means of the device crossways a range of farm duties and contexts applicable to terbutaline therapy for preterm work; and (c) comments of nurses indoctrination the device to achieve dissimilar tasks (Girvin, J. 1998). Device Operation: Computer-Based Infusion Pump No doubt, nurse caregivers carry out the initial system of the combination pump for terbutaline therapy for every patient. They agenda the infusion device to transport doses of medicine by means of exact intervals flanked by doses and set an fundamental basal rate, if wanted. The dose and release intervals are based on each human being patients medical supplies. Just the once the device has been routine by the nurse for an precise patient, the nurse teach the patient-operator on the customary tasks that the patient have to carry out at home to make sure that she be given the therapy as agreed and when wanted (Handy, C. 1999). Shocking encoding or use of the device can result in under or over management of terbutaline. Breakdown to productively function the combination device or failure to manage preterm labor can have unreliable degrees of crash: a call to the nurse, a journey to the hospital, a protracted hospital stay, or early delivery (Mullins, L. 2004). Another type of breakdown occurs when a patient is screen out as a possible applicant for terbutaline treatment at home since she is not capable to operate the pump productively (Kotter, J. 2001). The specific device in query is a moveable, battery-operated electronic infusion pump. It is one instance of a class of mixture devices for use with therapies requiring release of small volumes of high-concentration medicine (Roberts, K. and Ludvigsen, C. 1998). The medicine is pumped through a 107-cm long mixture set (tubing used to bring medication from the pump into the tissue) by means of a supple Teflon cannula (a needle less tubing attached to the mixture set) that is put in into the tissue just under the outside of the skin (subcutaneously). Infusion sites are chosen in the higher or lower stomach or the forward thigh and distorted every three to four days (Rolfe, G et al 2001). Users interrelate by the device from side to side four multifunction buttons: select (SEL), make active (ACT), up projectile, and down projectile. In standard, the SEL button permits the user to page through the dissimilar programming show (Semler, R. 2001). Moreover, the ACT button permit the user to "activate" the variety of screen displays in order to alter the settings. The up and downward arrow buttons agree to the user to augment or reduce the setting (for instance, to modify the time or to augment or reduce the medicine dose) (Semler, R. 2004). Multiple Modes According to the expert analysis the device function in a pecking order of multiple modes. Two control drug liberation: One is used for insulin therapy (rate mode), the additional for terbutaline therapy (gap mode). If the pump is set in the rate form, drug is delivered ceaselessly at a routine rate. When the pump is set in the gap mode, medicine is transport sporadically at an automatic dose size, or bolus by means of a time interval flanked by doses. In the gap mode, it is also possible to set a fundamental basal rate, which allows suppleness in the therapy agreed. They are intended for dissimilar medications in treating dissimilar types of medical setting (Peter Northouse, 2007). Investigating Device Use In Context If we analyzed then we come to know that there is three kinds of investigations were carry out. No doubt, nurses (all of whom were women) were interviewed concerning how they used the device and concerning their experiences by means of how patient-operators used the device. Moreover, the investigators demeanor bench tests of the device that travel around how it behaved, how the displays stand for those states and activities, and the control sequence wanted to interrelate by means of the device crossways a range of tasks and contexts pertinent to terbutaline therapy for preterm labor. Nurses were experiential as indoctrination the device to achieve dissimilar tasks (Billings, C. E., 1996). Conclusion Moreover, our investigations recognized more than a few classic human-computer communication deficiencies in this mixture device, given the background of terbutaline therapy to luxury preterm labor at home: lack of criticism on device state and behavior, multifaceted and arbitrary series of operation, vague alarms, and multiple operating modes future for dissimilar contexts. No doubt, these troubles occur frequently in computer-based devices in general and in computer-based devices for medical request (Cook, Potter, et al., 1991; Moll van Charante et al., 1993). No doubt, the mainly basic insinuation is the significance of avoiding design-induced human-computer stop working. In addition, avoiding design-induced human-computer stop working is the liability of growth organizations in the medical knowledge field as part of their design procedure. 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Visualizing function: The theory and practice of representation design in the computer medium. Manuscript in preparation. Woods, D. D., Johannesen, L., Cook, R. I., & Sarter, N. (1994). Behind human error: Cognitive systems, computers and hindsight. Dayton, OH: Crew Systems Ergonomics Information Analysis Center. Yue, L., Woods, D. D., & Cook, R. I. (1992). Reducing the potential for error through device design: Infusion controllers in cardiac surgery (Cognitive Systems Engineering Laboratory Report 92-TR-01). Columbus: Ohio State University. Jodi Heintz Obradovich is a graduate research associate in the Cognitive Systems Laboratory at Ohio State University, where she received her M.S. in industrial and systems engineering in 1996. David D. Woods is a professor in the Cognitive Systems Engineering Laboratory at Ohio State University. He received his Ph.D. in cognitive psychology from Purdue University in 1979. Read More