Leadership Practice in Health and Social Care - Essay Example

There are various theories and styles of leadership which are being applied in health and social care. The trait theory indicates that individuals are either born or not born to be leaders, and that individuals possess inherited qualities which can help ensure effective leadership (Siegel, 2009). These qualities include intelligence, sociability, as well as drive or determination. This type of leadership also supports physiological qualities which predict leader emergence as well as effectiveness, including qualities like appearance, height, weight, age, personality, self-confidence, decisiveness, knowledge, drive, persistence, sociability and cooperativeness (Siegel, 2009). In considering the application of this theory to leadership in health care, its basis has been sufficiently supported by other studies with genetic traits forming the foundation for human behaviour and attitudes (Siegel, 2009). This theory is also the basis from which other leadership traits can be evaluated. It provides detailed data in understanding the leadership process, especially in terms of the qualities which can help secure improved patient outcomes (Matthews, et.al., 2003). In assessing this type of leadership, it is important to argue that the qualities or traits needed in order to secure strong and effective leadership is supremely debatable. There are some discussions on the qualities which are essential for effective leadership (Gill, 2006). In effect, effective leadership may not always be based on qualities like drive or knowledge. It may be based entirely on qualities which are also inherited but are peripheral to the leadership traits mentioned above (Martin, 2003). The list of possible traits which would make up effective leadership are also numerous and for the most part, these qualities are simply general qualities. Physical traits like height or weight are also traits which need a better context of application (Martin, 2003). Minimum weight and height may be needed in order to carry out tasks efficiently in military leadership, however, in the health practice, height and weight are not considered necessary traits in securing effective leadership. Skills theory is also another leadership theory (Marquis and Huston, 2008). This theory highlights the fact that acquired skills are significant elements in securing effective leadership. It is the opposite of traits theory as it argues that more than inherited traits, acquired skills have a greater role in ensuring effective leadership (Marquis and Huston, 2008). This type of leadership is favourable as it supports the notion that most anyone can become a leader. Where the trait theory emphasizes on the fact that leadership is inheritable, the skills theory points out that individuals can work hard towards the establishment of skills needed in order to be good leaders (Marquis and Huston, 2008). In health care leadership, skills are often learned in the practice. Practitioners have to undergo significant skills training in order to be good leaders. They are not born knowing the applications in the health practice. Issues with this leadership theory come from the fact that there is a vague line between trait and skills theory. The establishment of various skills are based on personal traits (Johnson, 2009). For instance, social judgment and human skills are easier to establish for individuals who are naturally extroverts. Moreover, general knowledge and the power to secure skills are based on one’s biological traits (Johnson, 2009). The skills mode also does not provide explanations on why and how these skills impact on leadership. Instead, this theory highlights more the importance of identifying skills which are essential for leadership (Rowitz, 2009). The situational theory of leadership is yet another form of leadership which can be applied in the health care practice. This type of leadership indicates that various situations call for different styles of leadership (Ledlow and Coppola, 2011). In the field of healthcare, there is no particular style of leadership which can be applied to patients. Patients have different needs and face varying issues, effective leadership is about making the necessary adjustments in order to secure improved patient outcomes (Ledlow and Coppola, 2011). For health practitioners, the emphasis of effective practice is patient-centred care. Situational leadership would help secure such care. The adjustments are essential for each patient, allowing for the specific needs of patients to be managed while also considering their current situation (Ledlow and Coppola, 2011). In applying this form of leadership, issues may however arise when more relevance or importance is attributed to the situation, not so much on the personal traits of the individuals involved (Goodwin, 2006). Leadership also has to involve both traits and situations, however situational leadership only considers the environment and the events surrounding the incident subject to leadership resolution (Goodwin, 2006). There are other peculiar qualities which leaders need to evaluate as they apply situational leadership, and traits as well as specific skills also have a major role to play in the resolving these incidents (Goodwin, 2006). In effect, situational leadership does not allow for a complete explanation of the leadership process. Nevertheless, this leadership style is beneficial in as far as it makes the leadership process more personal and engaging for members (Healey and Marchese, 2012). The focus is less on the leader and more on the members, and on how the leader can successfully navigate the tasks required in order to ensure the efficient management of tasks and responsibilities. One of the newer theories of leadership is the transformational leadership. This type of leadership supports the fact that leadership is a process wherein individuals engage with others and establish a connection which eventually leads to better motivation and reality among the followers and the leaders (Novick, et.al., 2008). This type of leadership often includes charismatic leadership which supports the notion that leaders have certain qualities including confidence, extroversion, and values which eventually motivate followers or members (Novick, et.al., 2008). In the healthcare practice, transformational leadership includes the importance of paying specific attention to the needs and motives of other health practitioners in order for these members to eventually reach their full potential (Marshall, 2010). Moreover, transformational leadership also underlines how leaders can initiate and implement important changes within the organization. In the healthcare practice, there is a need to constantly be updated in the latest interventions for specific illnesses of patients (Marshall, 2010). New gadgets and interventions come about in an attempt to transform the practice into a better and more responsive one. This type of leadership therefore supports innovation and the application of change in the organization. Issues with the application of this form of leadership are however apparent because it seems to assume follower motivation (Swansburg, 1996). This type of leadership does not include situational elements, as it already considers that followers are working together in order to secure organizational goals. Moreover, transformational leadership is also not as effective in situations where the members do not have the sufficient skills in order to complete tasks (Swansburg, 1996). This form of leadership can also be time-consuming as securing its processes can take up much time for the leaders. Moreover, where the members do not share the vision of the leader, the results of transformational leadership may be frustrating (Marshall, 2010). Transformational leadership is also highly dependent on the individual. Most of its essential processes are based on the values and personalities of leaders (Marshall, 2010). Where other forms of leadership can secure a better alignment in style based on the needs of the organization, transformational leadership is beyond the reach for individuals who do not have the inspirational communication skills (Borkowski, 2009). Moreover, this form of leadership assumes the presence of one leader, and ignores the fact that there may be several leaders in one organization or in one activity. This is the case in health care where several leaders are often involved in the administration of patient care (Borkowski, 2009). One patient needs the leadership and guidance of various health professionals, and the collaboration of these leaders is a more essential element in the establishment of improved patient outcomes. Factors and variables influencing behaviour of individuals and teams and their performance in organizations There are various elements influencing the behaviour of individuals and teams and their performance in organizations. One of these elements is the relationship between the employee’s or the member’s commitment and organizational citizenship behaviour (Dickinson, 2009). Studies have indicated that organizational commitment refers to the psychological attachment which individuals have for their organization. The basis for such attachment is often founded on the individual’s compliance seen when the attitudes and behaviours of the organization are adopted because of the need to secure specific rewards (O’Reilly and Chatman, 1986). Identification and affiliation can also be seen in how individuals accept the influence of the organization and how they seek to maintain a satisfying relationship with them. Internalization and value congruence also indicates how individuals value their membership in any organization (Dickinson, 2009). Through these elements, members of a group are able to identify with the organization, often securing a psychological affinity to their organization. Job Stress, work-family conflict are also elements which affect an individual’s behaviour within the organization (Dickinson, 2009). Various studies have been able to establish a strong relationship between job stress, work-family conflicts and organizational citizenship and behaviour (Dickinson, 2009). Through these studies, it can be deduced that where employee participates in extra-role behaviour which is more than what is expected to them, stress can set in (Bolin and Turnley, 2005). These studies were also able to assess how non-work related activities, including family concerns can impact on the lives of employees and organization members. Work-family conflicts refer to role conflicts wherein family demands interfere with work and vice versa (Greenhaus and Beutell, 1985). Where employees consider more time in their work, they are also less likely to spend time with their families. In effect, it is possible for the employees who participates the most in organizational activities to be less fulfilled in their home lives (Bolino and Turnley, 2005). It is also important to note that organization citizenship is positively related to job stress and work-family issues (Dickinson, 2009). In other words, participating more in organizational citizenship activities can have a negative impact on the well-being of employees outside their work place. Another factor influencing behaviour of individuals and teams and their performance in organizations is the employee’s fairness perceptions (Dickinson, 2009). Organizational justice refers to the impact of fairness in the workplace. It involves the different ways employees ultimately decide whether or not they are being treated fairly in their work, and how their decisions impact on their work behaviour (Moorman, 1991). Two commonly evaluated processes in organizational justice include distributive justice and procedural justice. Distributive justice evaluates the fairness of the results which employees get; and procedural justice refers to how just the processes are which later impact on the outcomes seen (Moorman, 1991). Procedural justice includes formal processes and interactional justice. These formal processes include considerations on organizations application of fair procedures, including organization consistency in procedures. Another element of procedural justice is interactional justice. This includes the idea that beliefs on procedural justice can emerge from organizational procedures and how they implement these procedures (Moorman, 1991). Interactional justice is an element of procedural justice as it has been discovered that where managers carry out certain actions within the organization, how they explain their decisions has a significant impact in determining if procedural justice does exist (Bies, 1987). Fairness perceptions have a huge role in securing organizational citizenship behaviours (Dickinson, 2009). The foundation of this theory is based on the premise that if employees believe that they are being adequately managed, they would want to reciprocate the favourable treatment which their organization secures for them. The study by Organ (1988) also emphasizes why fairness perceptions can be linked to organizational citizenship behaviours. He emphasizes that if employees believe something is unfair in their organization, they may also change their organizational citizenship behaviour. They consider this a better option than changing the behaviour which they believe is actually required by their work (Organ, 1988). In a study assessing the relationship between fairness perception and organization citizenship behaviour, the causal modelling was used to evaluate paths leading to organizational citizenship behaviour based on justice perceptions (Dickinson, 2009). The primary goal for the study is to evaluate the link between perceptions of organizational justice through distributive and procedural justice as well as organizational citizenship behaviour (Moorman, 1991). The study established support for the causal relationship between procedural justice and organizational citizenship behaviour (Moorman, 1991). Moreover, the results indicate that the link between interactional justice which is an element of procedural justice and organizational citizenship behaviour seems to have a strong correlation with member behaviour. These results support the concept laid out by Organ (1990) where he revealed that employees who perceive unfairness in their organization would likely limit their extra-role participation in the organization; on the other hand, members of the organization who perceive fairness would likely participate more in the organization (Organ, 1990). Moreover, when employees believe that their company is being managed fairly, they are also more likely to perceive citizenship as a favourable element of social exchange (Moorman, 1991). Leader-member exchange also plays a significant part in influencing behaviour of individuals and teams and their performance in organizations. In a study by Wang, et.al., (2005), the relationship of leader-member exchange and its impact on task performance was evaluated. The leader-member exchange theory includes the reciprocal social relations which occur between the leader and the follower (Wang, et.al., 2005). The leader expresses expectations to the followers in terms of the roles which they are expected to perform, and in turn the members have role expectations about their leader in relation to how they expect their leader to treat them. These elements converge in a series of exchanges between leaders and followers, specifically known as leader-member exchange (Wang, et.al., 2005). In the study by Wang and colleagues, leader-member exchange is expected to favourably impact on the performance of tasks because the performance tasks is the best way by which followers can secure better reciprocity (Wang, et.al., 2005). These factors affect the behaviour of the members of the organization because of their physical and psychological impact on the member (Dickinson, 2009). Perceptions of justice, stress, family issues, as well as favourable relations with leaders are elements which impact on the employee and ultimately, his performance within the organization (Dickinson, 2009). For leaders wanting to improve member relations, securing strong and open relation with their members is likely would likely help improve the performance of the organization within the larger context of organizational management. Critically appraise change management strategies and their relevance to local and national policy development and practice Change management strategies include situational awareness, supporting structure, and strategy analysis (Wenderoth, 2009). Situational awareness includes understanding the change being introduced, understanding the people and individuals affected by the change, and developing a map of who would be impacted in the organization by the change (Toner, 2009). Supporting structure includes the identification by the change management team of who would be carrying out the change management work. Sponsor coalition also identifies the leaders which have to participate in order for the change to be successful (Toner, 2009). Strategy analysis includes risk assessment and anticipating resistance. Identifying special tactics which would be needed in a specific change initiative is the final step in the change management strategy (Toner, 2009). Situational awareness is an important element in the local and national development and practice. Situational awareness in the healthcare context relates to emergency management; it is also often used in relation to computer systems in the collation of data in the emergency unit (Toner, 2009). In effect, the systems are tools, sometimes considered essential tools; however they cannot always by themselves ensure situational awareness. In order to secure situational awareness, the right data is needed to be given at the right time and the right person has to receive such information (Toner, 2009). The right person must also be able to analyze the information and to do something valuable with such information. Situational awareness is important to local and national policy making because contemporary data can be used in order to guide policy making. Situational awareness can provide the necessary assistance needed for disease detection as well as surveillance (Toner, 2009). Surveillance processes also secure an easier information flow which is sometimes not altogether common in healthcare. Change management strategies in relation to situational awareness however can be limited in its application because there is a need to consider how the diverse systems and programs work together to secure an integrated picture (Toner, 2009). Decision makers may also not be able to utilize these systems in order to effectively secure action during crisis. In the local scene, the actions and development processes may not always be deliberate or forthcoming (Toner, 2009). Moreover, despite the fact that situational awareness is based on actual data, the necessary information may not always represent real time information (Toner, 2009). Regardless of these issues however, situational awareness is still an essential element in securing policy development and practice. Change management strategies in terms of team structure and sponsor coalition are also essential in securing change strategies. Team management structures indicate who will be involved in the change management work. For organizations, it is important to lay out clearly who would be involved in the change management work. Change management for organizations would likely involve different people, however, without identifying the right people who would be involved in the process, gaps in the implementation of changes would become more apparent. There is also a need to secure a strong relationship between the project team and the change management teams. The end goal in change management is on enabling the implementation of specific and well-informed decisions (Baker, 2007). Leaders and managers also need to be highly involved in the change management process in order to promote success and effective processes. The various members of organizations may not often be involved in the process and communicate less with each other when changes are being carried out (Baker, 2007). Under these conditions, failures in the implementation of change would be apparent. Moreover, local and national development would also not be efficiently secured. Strategy analysis involves risk assessment. For local and national development and practice, risk assessment must be carried out in order to establish improved situational awareness (Sarie and Ogilvie, 2010). Assessing risks within groups can be a tedious process, however, overall and specific risks can be documented and can eventually help secure higher change management success. For local and national development, resistance is often expected because some groups may feel threatened by change (Sarie and Ogilvie, 2010). Moreover, there may be a significant amount of investment placed by some members and organizations on specific techniques. The change management process has to be supported on various levels within organizations in order to secure effective processes. Where risks cannot be managed within the local and national scenario, changes would not likely be accepted and inadequate processes would persist within the organizations. Conclusion The discussions above indicate the importance of effective leadership processes in the delivery of health care. Leadership is based on various theories which are supported by specific qualities. Based on the situations involved, the appropriate leadership styles and theories would likely apply. Various elements also affect member behaviour within organizations. These elements include family-work conflict, leader-member relations, as well as perception of fair practice within the organization. These factors either reduce or increase the participation of members within the organization. Finally, in relation to change management strategies, these strategies basically refer to situational awareness, risk assessment and organizational structure, factors which impact on the efficacy of change as well as the processes which can help secure improved local and national development. References Baker, D., 2007. Strategic change management in public sector organisations. London: Chandos. Bies, R., 1987. The predicament of injustice: The management of moral outrage. Research in Organizational Behavior, 9, pp. 289-319. Bolino, M.C., and Turnley, W.H., 2005. The personal costs of citizenship behavior: The relationship between individual initiative and role overload, job stress, and work-family conflict. Journal of Applied Psychology, 90, pp. 740-748. Borkowski, N., 2009. Organizational behavior in health care. London: Jones & Bartlett Learning. Dickinson, L., 2009. An examination of the factors affecting organizational citizenship behavior. The University of Tennessee at Chattanooga [online]. Available at: http://www.utc.edu/Administration/DepartmentalHonors/DickinsonL.pdf [Accessed 10 December 2012]. Gill, R., 2006. Theory and practice of leadership. London: SAGE. Goodwin, N., 2006. Leadership in health care: A European perspective. London: Routledge. Greenhaus, J. and Beutell, N., 1985. Sources of conflict between work and family roles. Academy of Management Review, 10, pp. 76-88. Healey, B. and Marchese, M., 2012. Foundations of health care management: Principles and methods. London: John Wiley & Sons. Johnson, J., 2009. Health organizations: Theory, behavior, and development: theory, behavior and development. London: Jones & Bartlett Learning. Ledlow, G. and Coppola, N., 2010. Leadership for health professionals. London: Jones & Bartlett Publishers. Marshall, E., 2010. Transformational leadership in nursing: From expert clinician to influential leader. London: Springer Publishing Company. Martin, V., 2003. Leading change in health and social care. London: Routledge. Marquis, B., and Huston, C., 2009. Leadership roles and management functions in nursing: Theory and application. England: Lippincott Williams & Wilkins. Matthews, G., Deary, I., and Whiteman, M., 2003. Personality traits. Cambridge: Cambridge University Press. Moorman, R., 1991. Relationship between organizational justice and organizational citizenship behaviors: Do fairness perceptions influence employee citizenship? Journal of Applied Psychology, 76, pp. 845-855. Novick, L., Morrow, C., and Mays, G., 2008. Public health administration: principles for population-based management: principles for population-based management. London: Jones & Bartlett Learning. O’Reilly III, C., and Chatman, J., 1986. Organizational commitment and psychological attachment: The effects of compliance, identification, and internalization on prosocial behavior. Journal of Applied Psychology, 71, pp. 492-499. Organ, D., 1988. Organizational citizenship behavior: The good soldier syndrome. Lexington Books. Rowitz, L., 2009. Public health leadership: putting principles into practice. London: Jones & Bartlett Publishers. Sarie, M. and Ogilvie, L., 2010. Strategic planning for nurses: Change management in health care: change management in health care. London: Jones & Bartlett Learning. Siegel, L., 2009. Introduction to criminal justice. London: Cengage Learning. Swansburg, R., 1996. Management and leadership for nurse managers. London: Jones & Bartlett Learning. Toner, E., 2009. Creating situational awareness: a systems approach [online]. Available at: http://www.iom.edu/~/media/Files/Activity%20Files/PublicHealth/MedPrep/Jun-10-11-2009-Commissioned%20Papers/Jun-10-11-2009-Commissioned-Paper-Creating-Situational-Awareness-A-Systems-Approach.pdf [Accessed 10 December 2012]. Wang, H., Law, K., Hackett, R., Wang, D., et.al., 2005. Leader-member exchange as a mediator of the relationship between transformational leadership and followers’ performance and organizational citizenship behavior. Academy of Management Journal, 48, pp. 420-432. Wenderoth, M., 2009. Change management strategy for implementing shared services. Germany: GRIN Verlag. Read More