Organisational Effectiveness and Service Improvement - Essay Example

Aims This paper aims to establish the comprehension of the s and unit topics covered by this It also aims to assess the knowledge that the student has learned in an issue related to leadership and management in healthcare. This study now aims to apply the theories on leadership and management discussed in the sessions of this course. Background There are different theories explaining management in organizations. These theories range from the classical to the scientific. The classical theories set forth responsibilities and expected attitudes from both the manager and the members of the organization. These classical theories do not take into account individual characteristics of each member and each member’s capacity for potential leadership. Newer theories by Taylor and Weber offer more scientific principles and explanations for management and leadership. Through these theories, we can deduce various techniques in leadership. We can also deduce various elements of an effective team. Conclusion The various elements of an effective team are: a meaningful and clearly defined task; clear team objectives and individual targets; regular meetings; regular feedbacks on individual and team success in achieving objectives; the right balance of people; reflexivity-the ability to reflect on team performance and adapt and change; a good balance of concern for the team task and concern for the team welfare; the experience of full participation; and good leadership. Summative Assessment: Organisational Effectiveness and Service Improvement AIMS This study aims to establish the student’s comprehension of the subjects and unit topics covered by this course. It also aims to apply the knowledge that the student has learned in an issue related to leadership and management in healthcare. This study aims to apply the different theories on leadership and management which were discussed in the different sessions of this course. INTRODUCTION Strong leadership and management skills are important tools for members of the health care team. Without effective leadership skills, the implementation of health care services becomes a counterproductive enterprise. In the nursing care process, the nurse is often called on to be a manager, and in some instances, she is also called on to be a leader. Both roles are different from the other. Wywialowski (1993) refers to nursing management as “the judicious use of resources to achieve identified client goals”. The responsibilities of the nurse manager include directing and controlling. He distinguishes nursing management from leadership by defining the latter as “the ability to influence others to respond in desired ways, for example, to relate to others in ways that encourage them to voluntarily follow” (Wywialowski, 1993). In other words, the nurse manager has a more imposing role in the organization by virtue of the position he is occupying in the organization. The nurse leader on the other hand acts in a more persuasive manner, encouraging others to follow her lead. There are different theories explaining nursing management and leadership. These theories will help us understand effective leadership and teamwork. Each leader is expected to use his or her technique in leadership. These techniques are bound to affect the effectiveness of a team and the delivery of health care services. BACKGROUND OF THE STUDY Different theories have been used to conceptualize and explain management and management techniques. Henry Fayol was one of the first and most notable theorists who attempted to further explain management. Fayol set forth his 14 principles of management where he laid down important precepts which have been supported by various managers in their practice. His principles cover the importance of division of labor, authority and responsibility, discipline, unity of command, unity of direction, subordination of individual interest to general interest, remuneration, centralization, scalar chain, order, equity, stability, initiative, and esprit de corps (as quoted by Mullins, 2004, Cole, 1996). These principles set forth responsibilities and expected attitudes from both the manager and the members of the organization. They represent common end goals that members and managers need to aim for in order to achieve an effective organization. Theorist Lussato (1976) offered a summary of principles common in the classical management theories. He emphasized that in the previous theories, there is a principle of hierarchy with authority descended from top to bottom; that delegation should be maximized, that individuals must only receive orders from on superior, and that routine tasks should be performed by subordinates while exceptional tasks should be performed by superiors. These classical theories have been criticized for their lack of concern with the interaction between people, their underestimation of the defects of conflict, their underestimation of the capacity of individual workers to process information, and their misunderstanding of the way people think (March & Simon, 1958). In other words, these classical theories do not take into account individual characteristics of each member, and each member’s capacity and potential for leadership. Newer theories were suggested in order to explain management. Frederick Taylor presented some interesting ideas that can be applied in nursing management. He suggests primarily that “the principal object of management should be to secure the maximum prosperity for the employer, coupled with the maximum prosperity for each employee” (Taylor, 1911). This principle implies that the goals of management should not only be focused on gaining success for the employer and the management; but it should also be geared towards gaining prosperity for the employees. He also pointed out how scientific principles can be applied to individual workers in order to improve productivity. Taylor emphasizes that successful management can be achieved through the clear division of tasks and responsibilities between management and workers and the application of scientific principles in order to assess the best time and method to do a particular job. Weber’s management principles were also introduced. His principles were mostly about the increasing authority and responsibility of the manager and about rigid rules and regulations, about fixed and limited duties. Weber implies that both the manager and the members of the organization have essential qualities and responsibilities to fulfill in order to establish a successful organization. After considering the above theories and information, we now assess the factors that contribute to effective teamwork. DISCUSSION Mohrmon, et.al., (1995) defines a team as “a group of individuals who work together to produce or deliver services for which they are mutually accountable”. A team should then have the following characteristics: a clearly defined team role, clear shared objectives, members working together to achieve objectives, members having different roles, and is recognized by outsiders as having a specific function. In the field of healthcare, much of the work and care of the patient entails team work. The patient is actually in the hands of a healthcare team. This team is composed of doctors, nurses, midwives, pharmacists, laboratory technicians, dietitians, nursing attendants, and hospital cleaning crews. Through the combined efforts of this health care team, the patient can receive the highest quality of health services. Research evidence also point out various benefits of working in teams. These researches claim that there are lower mortality rates when effective teams are in place. Hospital admissions and costs are also reduced through team work. Team based primary care has also been known to reduce the duplication of health services. Finally, there is also better staff retention and turnover because of well functioning teams (West, et.al., 2002). For employees working well in teams, there are decreased stress levels and better mental wellness. Role clarity is made possible and members are eager to support each other as members of the team. These members are also insulated from workplace conflict and negative organization culture (West, et.al., 2002). The team I am currently working with is effective because we have the following: a meaningful and clearly defined task; clear team objectives and individual targets; regular meetings; regular feedbacks on individual and team success in achieving objectives; the right balance of people; reflexivity-the ability to reflect on team performance and adapt and change; a good balance of concern for the team task and concern for the team welfare; the experience of full participation; and good leadership. Meaningful and clearly defined task There is a need to define the tasks of the different members of the health care team. In any team or organization, it is important to set clear goals and objectives. These objectives should be SMART (specific, measurable, attainable, relevant, and time bound). Specific goals help set the boundaries of a task. It helps the team understand the details of the work that they are about to undertake. Some authors and practitioners emphasize that “objectives should be clear and specific enough to drive action” (Griffin, 2006, p. 34). Measurable objectives help the team measure and assess their progress. It helps them determine if their goals are accomplished and how well they have accomplished these goals. Attainable goals or objectives focus on what the team can achieve based on resources and capacities (St. John & Keleher, 2007, p. 210). In other words, this goal must also be realistic. Realistic goals emphasize the sensibility and the practicality of the objectives. The team must know what it has to work with and how far its resources can take them. Impractical and insensible objectives tend to present difficult and near impossible goals for the team. They also increase frustration when these goals are not actually met. Objectives should also be relevant. In this instance, the question “will this objective lead to the desired result?” is asked by the team. This means that they should assess if the result or outcome of their efforts would directly support the outcomes of the organization’s long term goals. The team must also consider the bigger picture; and whether or not the objectives it is setting actually fits the goals of the organization it is part of. Finally, objectives of the team must also be time-bound. They would now ask themselves when the objectives will be accomplished. They need to set a deadline and a time frame for their activities (March of Dimes, 2006, pp. 1-3). This will then help the members of the healthcare team in planning their activities. As the members are aware that they have deadlines to meet, the sense of urgency and activity will now affect the way they would manage their time. Clear team objectives and individual targets Accurate and precise objectives increase the likelihood that a team will be able to improve its overall performance. Goals and visions must be set clearly before the team can function well. The unit session emphasizes that “it is important for the team as a whole to have clear team goals with performance feedback, because where people set clear targets to aim for, their performance improves”. In our organization and in our healthcare team, we set regular feedback checks in order for us to assess the performance of the group using the key indices set in the team goals. West (2004) points out the value of these feedbacks when he argues that “in health care organizations, there should be regular (at least annual) feedback on a range of key indices”. In the UK, some of these key indices have been used by the Department of Health in order to measure organizational effectiveness. These indices include patient satisfaction with the quality of care given, effectiveness of new innovations in clinical practice, financial effectiveness, and effectiveness in reducing waiting times. By using these indices, the health care team is now aware of what its end goals are and of what each member needs to do in order to function well. Regular meetings Regular meetings in a team are essential elements of teamwork. “Continuous updates to all team members enhances shared understanding and means that everyone will know where successes have been achieved or problems have been encountered” (National Patient Safety Agency, 2008). Regular meetings also ensure that the members are aligning their activities with the team and the organization’s goals. It also updates the members of possible changes in the circumstances of the team or the activity itself and if they need to make necessary adjustments in their assigned task. A report by Borill, et.al. (1999, p. 9) revealed that regular meetings are related to effective communication. Communication is an essential part of teamwork; and regular meetings offer a quintessential opportunity to keep the lines of communication in the team open. The authors actually point out that “communication and regular meetings in PHC and CMC health care teams are associated with higher levels of effectiveness and innovation…” (Borill, et.al., 1999, p. 9). In keeping with the elements of an effective team, we hold weekly meetings. Through these meetings we assess our activities and the progress of our assigned tasks. We also update ourselves on possible changes in the team and in our assigned tasks and goals. We offer feedbacks on our own and on other member’s activities, and make appropriate changes when necessary. Regular feedbacks Regular feedbacks can be achieved during the regular meetings. In the health care setting, feedback is important in setting goals and in fostering high team commitment (Lathom, et.al., 1988, as quoted by Borrill, et.al., 1999, p. 25). When the members of the health care team are satisfied with their work, regular feedback helps reinforce such satisfaction. However, in instances when there are long cycles of work or in instances of one-off projects, it is often difficult to give regular feedbacks (Sundstrom, et.al., 1990, as quoted by Borill, et.al., 1999, p. 25). Hence, in these instances, members and team leaders have to come up with ways to provide regular feedback and reinforce each other’s morale. Authors and other practitioners emphasize that teams need timely and appropriate feedback on their performance in order for them to function effectively. This feedback should occur as soon as the team or the members have performed the task; it may also occur regularly in order for the team to make the necessary adjustments in their performances (Borill, et.al., 1999, p. 244). The right balance of people A team needs the right people in order to function well. Specific skills have to be possessed by members in order for the team to accomplish its goals. Manion, et.al. (1996, pp. 74-75) categorize team skills into four categories. These are: technical and functional expertise, interpersonal skills, team process skills, and supervisory and management skills. Technical skills are important especially in the healthcare practice because they determine the quality of healthcare services that the patient will be receiving. The technical skills depend largely on the function of the team. An orthopedic care team needs a group of professionals distinct from an obstetrics team. An operating team is also different from an emergency unit team, and so on and so forth. Interpersonal skills fall mostly in the hands of the supervisor and the manager. These skills are needed in order to keep the lines of communication between and among the members of the healthcare team open. Through these interpersonal skills, managers and leaders have the opportunity to bring out the best in their members (Hood, et.al., 2006, p. 533). A team also needs people with team process skills. Team process skills mostly refer to the ability to deal with conflicts and communication problems, power and authority, and leadership concerns (Drinka & Clark, 2000, p. 169). These issues need to be dealt with before a team can attain its desired level of success. Lastly, a team needs supervisory and management skill. These skills fall on the leaders and managers of the group. Supervisory and leadership qualities shall be discussed in detail at the end of this discussion. Reflexivity Another element of an effective team is reflexivity, or the ability to reflect on team performance and adapt to change. West defines reflexivity as “the extent to which group members overtly reflect upon the group’s objectives, strategies and processes, and adapt them to current or anticipated endogenous or environmental circumstances” (1997, as quoted by Firth-Cozens, 1998, p. S5). The element of reflection is important in this regard because it enables the team to make the necessary adjustments and changes in its activities. Good balance of concern for the team task and concern for the team welfare In order to be an effective team, the members must be able to achieve a balance between the team’s task and the team’s welfare. Dyer, et.al. (2007, p. 62) emphasize that “team members should understand that successful teams show a concern for getting the task done but also concern for managing relationships”. Managing relationships within the team helps to enhance teamwork and job satisfaction. Members need opportunities to be open with each other, to be comfortable with each other, and to basically encourage each other in their assigned tasks. Full participation Full participation is also another essential element of an effective team. Full participation helps the members achieve the shared goals of the organization. It is important for healthcare teams to realize that “effective interdisciplinary work incorporates the goals and opinions of all professions in the treatment plans, and each profession shares responsibility for carrying out the treatment” (Davidson, 1990, Mailick & Jordan, 1977, as quoted by Sontag, 2001). Through full participation, the team’s objectives and tasks would not seem very daunting and difficult to accomplish. Good leadership Good leadership is a quality which is difficult to secure in any team. Various authors suggest different traits needed in good leaders. Different theorists have also expressed their opinion on the topic of good leaders and good leadership. The trait theories emphasize that leaders are born not made and good leaders already have inherent characteristics which set them apart. Buchanan and Huczynski (2005), identify desirable traits of a leader, and these cover integrity, initiative, judgment, energy, foresight, and objectivity, among others. In a nurse leader, I would consider integrity and objectivity as desirable traits because with these traits, others can easily follow. The Repertory Grid also identifies genuine concern for others, inspirational communicator, empowering others to lead, transparency, and charisma as desirable traits they look for in a leader. Another theory – the functional leadership theory – sets forth essential elements of good leadership. This theory emphasizes that leadership resides in the functions, not on a particular person. The skills required by leaders can actually be learned and developed, and that leadership functions depend on the nature of the group. John Adair’s Action Centered Leadership is an example of the functional model. This model emphasizes that an effective leader must focus on the task, the team, and the individual functions. It focuses on what the leader is supposed to do and how he does it. The style theories differentiate between the autocratic and the democratic styles of leadership. The autocratic style is focused on the work, on technical activities, and on deference to medicine. There is also little devolution of responsibility and poor channels of communication. On the other hand, the democratic style is more work dynamic and patient centered, is focused on creativity, and with the nurse more accountable and autonomous. There is also more control of the environment and more organizational communications. This theory points out that there is a need to adjust leadership styles accordingly based on the situation being faced by the team. CONCLUSION Various theories explain management and leadership in the healthcare system. These theories explain that there are various qualities that leaders possess in order to produce an effective team. Effective teams have essential elements. These elements help ensure that the team has common goals, that members have the proper skills to be members of the team, and that leaders have qualities that strengthen the team. These elements are enumerated as follows: a meaningful and clearly defined task; clear team objectives and individual targets; regular meetings; regular feedbacks on individual and team success in achieving objectives; the right balance of people; reflexivity-the ability to reflect on team performance and adapt and change; a good balance of concern for the team task and concern for the team welfare; the experience of full participation; and good leadership. 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