Leadership and Management at St Lukes Medical Center in the Philippines - Essay Example

LEADERSHIP AND MANAGEMENT INTRODUCTION One of the most exciting and challenging theories encompassing human behavior in organizations is leadership.Leadership is the process of influencing people to work or act towards the attainment of specifically defined goals (Martires & Fule 2000: 569). There have been a significant number of literatures covering the nature, theories and applications of leadership and its effect to job performance and satisfaction. The diverse patterns of behavior and actions that leaders exhibit over a period of time and perceived by followers have been identified as the dominant style of leadership. This style is developed utilizing an interplay of factors which shape leadership development. In health care, like in any other enterprise, administrative issues that call for immediate change affecting the relevant structures of the health institution are ultimately governed by the CEO or the board of directors. It is in this regard that this paper aims to explore the management changes within a health care organization, the St. Luke’s Medical Center in the Philippines, considered as one of the top 10 hospitals in Asia, and examine the obstacles faced by their senior management during the process of change. The choice of organizational development methods used to design a flexible strategy would be examined to the extent of its ability to cope with the changing needs of the company. ORGANIZATIONAL CHANGE The mission of St. Luke’s Medical Center is to improve the delivery of quality health care conforming to the strict standards of the Joint Accreditation Commission of Health Organizations (JACHO 2008). It came to the attention of the Vice President for Nursing that their Nurse Managers are torn between prioritizing functions which are administrative in nature vis-à-vis functions that cater to the delivery of patient care. Due to the Nurse Managers’ theoretical orientation for health care, the administrative tasks such as completion of reportorial requirements, monitoring and upkeep of equipment and supplies, staff requirements and budgeting are frequently neglected or seconded with priorities being focused to patient care. In this regard, the VP for Nursing sought the assistance of the VP for Human Resources and the CEO to resolve this issue. CASE BACKGROUND, ALTERNATIVE COURSES OF ACTION AND DECISION Every nursing unit in the hospital is headed by a nurse manager who is assigned as the chief head nurse on duty. Her job responsibilities entail patient care as the primary task and managerial functions such as planning, directing, staffing and control. These multi-task functions coupled with low pay contributed to low morale and low productivity. These nurses opted to gain the minimum experience required to enable them to leave the country and work abroad. The leadership function assigned to nurse managers conflict with their functions as providers of patient care. They are expected to deliver timely reports on a daily, weekly and monthly basis. They monitor staffing requirements. They prepare the time sheets for payroll purposes. And most importantly, they are expected to know all the nursing intervention requirements for all the patients are their nursing units. There is this question on prioritization of function. As nurses, of course, they should prioritize patient care. But as managers, the function of attending to the human resource needs of the unit suffers. Reports are not completed on their specified time schedules. Upkeep of facilities in patients’ rooms and hospital areas are not regularly attended to. Equipments that need repair and reorder are forgotten. Staff vacation leaves are not properly plotted and thereby not taken as scheduled. Performance evaluation and appraisals are not conducted regularly for monitoring purposes. All of these functions are important managerial functions which would create an improvement in productivity and morale of a hospital unit. All of these should be attended to ensure customer satisfaction and efficient delivery of health service. What were the alternative courses of action open to management to solve this problem? The officers and top management of this hospital were aware that there were several options open to them, among which are: 1. Separate the patient care and managerial function from the nurse managers. 2. Hire administrative managers to take care of the managerial functions. The officers, members of the board of directors, and the CEO of the hospital deemed it appropriate to hire non nurse unit managers who possess graduate degrees in business, to head the different nursing units. These unit managers have the sole responsibilities of ensuring compliance to reportorial requirements, human resources issues, facilities and equipment, budgeting, and other aspects of the units’ operations – except patient care. POSITIVE AND NEGATIVE ASPECTS OF MANAGEMENT’S DECISION This solution was first met with complaints especially from the nurse managers who perceived the new position as a threat to their existence. They feared that they would eventually lose their “managerial” position and revert to a “staff” position since they would be relieved of the managerial functions and concentrate on patient care. However, top management assured them that this strategic move would enable them to focus on their primary concern as nurses and at the same time, take additional training courses to improve their nursing skills. Management developed another career path open to them which would eventually make them capable of becoming department managers and maybe, eventually, vice presidents for nursing. This move paved the way to increase morale and productivity in the units, and increased patients’ satisfaction with regard to the delivery of efficient and effective healthcare. ANALYSIS Every organization exists to achieve a purpose. In order to attain organizational goals, a set of policies and strategies are defined and developed by management. As averred by Christensen, Andrews, & Bower (1978: 3), policy is “the study of the functions and responsibilities of senior management, the crucial problems that affect success in the total enterprise, and the decisions that determine the direction of the organization and shape its function”. Policies and strategic management are responsibilities of the chief executive officer (CEO). A major task under these responsibilities is corporate governance which is simply defined as “controlling, restraining and directing the making and administration of these policies” (Webster 1997: 327). Any leadership approach involving top management entails a form of governance. CONCLUSION In resolving issues pertaining to management changes, it is pertinent that problems are properly and accurately identified. Leaders are assigned and employed to do their tasks. Systems are installed to implement the necessary changes. However, when a gap still exists between knowing and implementing the solution, the top honcho should take the helm and assume responsibility in decision making. As timely recommended by O’Neil (2008), the leaders should create and head the teams to solve the problems. It should be a direct application experience. Leaders should not be wary or afraid to get their hands dirty for the sake of saving lives. By being part of the action team, only then can these leaders be assured that the solutions carefully drawn and crafted are efficiently and effectively implemented. References Christensen, C.R., Andrews, K.R., & Bower, J.L. (1978). Business Policy: Texts and cases. Richard D. Irwin, Inc. Homewood, Illinois. Martires, C.R. & Fule, G.S. (2000). Management of Human Behavior in Organizations. National Bookstore. Philippines. O’Neil, M. (2008). Human resource leadership: the key to improved results in health. Human Resource for Health, open access article. Retrieved on April 20, 2009 from St. Luke’s Medical Center. (2009). One of the World’s Best. Retrieved on April 22, 2009 from The Joint Commission 2008 Requirements Related to the Provision of Culturally and Linguistically Appropriate Health Care, April 2008, retrieved on April 21, 2009 from http://www.jointcommission.org/NR/rdonlyres/6941959E-D4BE-48D7-A2F8-A4834E84B263/0/JC_Standards_D... · Cached page · PDF file The Merriam-Webster. (1997). Definition of Governance. Merriam-Webster, Incorporated. Springfield, Massachusetts, USA. p. 327. Read More