Nursing Organization Leadership and Policy - Essay Example

Organization and Leadership Introduction Governments today make heavy investments in the healthcare system to improve the health status of their citizens. However, many countries still struggle to deliver quality patient services that would justify their increased health spending. Health policymakers believe that massive healthcare spending can contribute nothing to care quality and patient safety unless the base of the healthcare system is strengthened. They say that nursing leaders can play a significant role in enhancing the patient outcomes and optimizing health costs. This paper will analyze the leadership process at a hospital facility and discuss how leadership, organization, and policy can influence patient outcomes. Nursing Leadership and Policy The hospital facility in which I work promotes transformational leadership approach to manage the nursing staff effectively and thereby establishes a patient-centered care. According to Harrison, “transformational leadership is defined as leadership behaviors that inspire followers, resulting in both leader and follower raising each other up to higher level of morality, motivation, and performance based on four categories of leader behavior, including idealized influence, intellectual stimulation, individualized consideration, and inspirational motivation” (Harrison, 2011, p.98). Transformational leaders are expected to identify the needed change, create a vision plan to achieve the change through inspiration, and execute the change with the support of committed members of the group. Referring to Edwards, Knight, Broome and Flynn (2010), the four crucial components of transformational leadership include idealized influence, inspirational motivation, individualized consideration, and intellectual stimulation. Idealized influence means the leader serves as an ideal role model for his/her followers whereas the component of inspirational motivation implies that transformational leaders have the potential to inspire and motivate others. The concept of individualized consideration reflects that this type of leaders express genuine commitment to considering the needs and feelings of the followers. Finally, intellectual stimulation means transformational leaders encourage the staff to be creative and innovative (Edwards et al). In this hospital facility, the nursing leaders rely on the transformational leadership approach to enhance the motivation, morale, and job performance of the nursing staff through a variety of mechanisms such as aligning the staff’s sense of identify with the collective identity of the organization; being a good role model for the followers; insisting the staff members to be accountable for their work; identifying the strengths and weaknesses of the followers; and continually working with them to enhance their performance. The transformational leadership is based on building relationships and keeping the followers motivated through a shared vision and mission. When adopting this leadership style, nursing leaders have the charisma to communicate the organization’s vision clearly and to act in a way that would inspire others. In addition, they are able to motivate people to perform tasks that they were not sure if they could do through encouragement and praise. While observing the nursing leaders at this health care facility, it seems that they are attentive to maintain all the characteristics of a transformational leader. In the words of Garcia, Duncan, Carmody-Bubb & Ree (2014), these characteristics represent personality traits including extraversion, neuroticism, and openness to experience, agreeableness, and conscientiousness. It is also identified that transformational nursing leaders have enhanced trust in their followers, believing that their best performance is yet to come. This leadership style really contributes to the overall organizational productivity because transformational leaders are capable of working with complex groups and settings. Under this leadership culture, the nursing staff feel a sense of belongingness and empowerment, which in turn would make them loyal and best performers. The hospital policy, which is rooted in staff empowerment and creativity, also supports the transformational leadership approach. The hospital management thinks that employees must be fostered and empowered to develop their own mechanisms to influence patient behavior and thereby produce better health care outcomes. Leader and Manager There are numerous differences between a leader and a manager. The major point of difference between a manager and a leader is that managers have employees whereas leaders win followers. When leaders create changes, managers are charged with the responsibility to react to changes. According to Ashby (2012), a leader tends to seek and support the objectives of his subordinates and therefore the mutuality of objectives between the leader and his audience is enhanced. In contrast, a manager may seek objectives that would not be acceptable to his subordinates and hence there may be a possible clash of objectives. A leader is generally innovative and he always looks at doing right things. On the other hand, a manager is generally bureaucratic and emphasizes on doing things right in accordance with the rules established (pp.282-283). These differences are visible in my work unit. Hospital managers generally set objectives in the best interests of the long-term prosperity and success of the organization. They may not consider the interests of the nursing staff or other employee while setting goals, and hence there is a likely clash of objectives between the staff and management. It seems that managers always try to exercise power over their followers whereas leaders seek to develop power with people around them. In the healthcare setting, managers are eager to take the credit of successes while leaders are interested to assume more responsibilities. If I were the leader, I would seek to assume more responsibilities to be a great role model for my followers and thereby motivate them to do right things. In addition, I would take efforts to create shared focus and to persuade the audience to go in line with the policies developed by the top management. I would always try to consider my followers’ opinions so as to provide them with a sense of empowerment. Handling Conflict A successful leader cannot ignore conflicts between the staff because workplace conflicts can have severe impacts on quality of services and patient safety. Developing a set of effective conflict resolution skills is important to build a sustainable business model. Unresolved worksite conflicts may lead to serious issues such as loss of productivity, decline of creativity, and the formation of barriers to cooperation and collaboration. In the perspective of successful leaders, good conflict resolution skills are vital to promote better employee retention. According to Yoder-Wise (2014, p. 433), defining what constitutes acceptable behavior is the first step in handling conflict. Evidently, an established framework for decision making, promotion of sound business practices in collaboration, leadership development, team building, and talent management would really assist nursing leaders to manage conflict situations effectively. A well-defined job description may aid the nursing staff to understand what the organization expects from them. Undoubtedly, conflict prevention is an important area of conflict management although preventing conflicts is not easy always. By intervening in a likely conflict situation, one may be able to prevent the conflict or mitigate the severity of its consequences. The nursing leader should not have any prejudice while handling a worksite conflict, and he/she must let all the parties involved in the conflict to justify their position to obtain clear understanding of the issue. Under any circumstance, the leader should not be partial, and the leader’s decision must be fair enough to protect the worksite interests of the parties involved in the conflict. Myatt (2012) suggests nursing leaders to view every conflict as a learning opportunity that offers inherent potential for growth and development. In addition to handling conflict situations effectively, the nursing leader must ensure that the workplace environment is not vulnerable to staff conflicts so as to attain the status of a successful leader. Influence of leadership, organization, and policy on patient outcomes Evidences suggest that the elements of leadership, organization, and policy can have noticeable impacts on patient outcomes. As discussed already, nursing leaders in my hospital facility adopt the transformational leadership style to influence their followers. As this leadership approach focuses on team-building and worksite collaboration, the nursing staff can relax, and this situation would minimize the chance of clinical errors. In addition, a relaxed worksite environment may increase the level of staff satisfaction, which in turn would improve the staff turnover rate. Under this leadership model, the nursing leader enjoys great control over his/her subordinates, and hence health outcomes could be enhanced to a considerable extent. Doran (2010, p. 278) indicates that there is a significant relationship between health care policies and patient outcomes. To illustrate, policymakers at my health institution emphasize the need of maintaining an improved nurse to patient ratio, which is the number of nurses assigned to care for a specific number of patients in the care facility. This policy makes sure that no staff nurse is forced to work overtime or care for more number of patients than what is required by law. It is identified that this better nurse to patient ratio assists the organization to add value to staff satisfaction and eliminate lawsuits associated with medical negligence. As this nursing policy is helpful to reduce the staff turnover rate, it can also benefit the healthcare facility to avoid staff shortage issues. The management allows the staff nurses to take leaves when it is necessary so as to keep employees refreshed and motivated. In addition to offering an attractive basic salary, this hospital unit provides the nursing staff with periodical increments and bonuses and keeps them loyal to the institution in the long term. The organizational structure of the hospital is competent enough to improve the patient outcomes. To make it clear, the organization fosters effective up and down communication across various departments in order to create and maintain a shared focus. As the staff members are encouraged to approach top management executives always to solve their work-related problems, there is a strong relationship between the management and staff. Measuring Patient Outcomes It is essential to measure patient outcomes regularly and report them to the hospital management so as to assist the top executives to be informed of the organization’s operational efficiency. A well-structured measurement and reporting system can assist the top management personnel to identify the operational pitfalls (if any) and take immediate measures to address those issues. It is advisable for the hospital facility to rely on a patient-reported outcome (PRO), which is a questionnaire used in the clinical setting, to collect responses directly from the patient. Deshpande, Rajan, Sudeepthi & Nazir (2011) reflect that although the medical technology has been developed enough to measure the physical, psychological, or biochemical data of the patient, it cannot provide all the data regarding the disease or treatment. As some data or information can be acquired only from the patient, the PRO is an effective strategy to measure comprehensive patient outcomes. To illustrate, the authors say that a patient can tell many things such as complaints, opinions, or thought that an observer or technology cannot and which is really valuable in the light of a comprehensive assessment of patient outcomes (Deshpande et al). In addition to programs like PRO, the health institution may also use technology and staff efforts to measure patient outcomes in many cases. In a research paper, McLeod, Coon, Martin, Fehnel & Hays (2011) report that the US Food and Drug Administration uses more crucial instruments to measure patient-reported outcomes in clinical trials. They add that the US FDA relies on PRO tools to facilitate decision making with regard to the approval of drugs, labels, and promotional claims. According to the authors, the FDA has even developed a methodology to define a responder and to analyze responder-based PRO results (McLeod et al). Similarly, many other leading public healthcare bodies depend on PRO techniques to measure accurate patient outcomes and to improve the delivery of health services constantly. Conclusion From the above discussion, it is clear that a transformational leadership approach is practiced in my hospital facility, and this leadership style has been keeping the nursing staff creative and motivated. The four crucial components of this leadership strategy include idealized influence, inspirational motivation, individualized consideration, and intellectual stimulation. When there is a mutuality of objectives between a leader and his followers, a manager’s objectives may not be the same as that of his subordinates, and hence there is a likely clash of objectives. In order to handle workplace conflicts effectively, it is necessary to define what constitutes acceptable behavior. It is identified that the leadership approach and nursing policy adopted in this hospital unit have a set of positive impacts on patient outcomes including elimination of medical errors and improved staff turnover rate. Patient-reported Outcomes (PRO) is a great strategy to measure patient outcomes accurately and to form clear understanding about the performance efficiency of the organization. References Ashby, F. C. (2012). Revitalize Your Corporate Culture. US: Routledge. Deshpande, P. R., Rajan, S., Sudeepthi, B. L & Nazir, C. P. A. (2011). Patient-reported outcomes: A new era in clinical research. Perspectives in Clinical Research, 2(4): 137–144. Doran, D. M. (2010). Nursing Outcomes. US: Jones & Bartlett Publishers. Edwards, J. R., Knight, D. K., Broome, K. M., Flynn, P. M. (2010). The Development and Validation of a Transformational Leadership Survey for Substance Use Treatment Programs. Subst Use Misuse, 45(9): 1279–1302. Garcia, M., Duncan, P., Carmody-Bubb, M & Ree, M. J. (2014). You Have What? Personality! Traits That Predict Leadership Styles for Elementary Principals. Scientific Research, 5: 204-2012. Harrison, J. L. (2011). Instructor Transformational Leadership and Student Outcomes. Emerging Leadership Journeys, 4 (1), 82- 136. Myatt, M. (2012). 5 Keys of Dealing with Workplace Conflict. Retrieved from http://www.forbes.com/sites/mikemyatt/2012/02/22/5-keys-to-dealing-with-workplace-conflict/ McLeod, L. D., Coon, C.D., Martin, S.A., Fehnel, S.E & Hays, R. D. (2011). Interpreting patient-reported outcome results: US FDA guidance and emerging methods. Expert Rev Pharmacoecon Outcomes Res. 11 (2):163-9. Yoder-Wise, P. S. (2014). Leading and Managing in Nursing. US: Elsevier Health Sciences. Read More