711

Leadership and Professional Communication

In Healthcare Management

Assessment #1

Submitted by:
Jobelle Angelica A Lara
DBH258

Submitted to:
Mohinder Singh
Patrick Okezie
Lecturer

6th November 2017

Introduction

Leadership is one of the keys to success in the healthcare. It is the process of

visualizing, interacting, communicating, influencing, motivating, challenging, taking
risks between everyone and taking a difference for a better world and making it
happen (Porter-O'Grady, 2003). Leadership is also the gateway in providing direction
towards achievement of healthcare goals and preferably aligning the staff. (Kelly-
Hiedenthal, 2004). Moreover, leadership is a collective process of planning, directing,
organising and controlling. An organised group is highly influenced by this dynamic
leadership process to achieve goals and tasks given. (Roussel & Swansburg,
Management and leadership for nurses administrators, 2006).

Leadership is also bringing out the best to an individual or group to achieve goals and
to take action in accordance to the leader’s purpose. It is also explained that
leadership can be an individual or a group that works together in achieving a common
goal. A group who is useful and well functioning can be one of the vital components
of leadership. Leadership can also greatly affect the performance, personality and
behavior of staff following their leader in order to provide exemplary care to people
(Roussel, Swansburg, & Swansburg, Management and leadership for nurses
administrators, 2006).

Leadership skills can develop naturally, if applied effectively and goal oriented.
Effective leaders need to be problem-solvers, effective in groups and effective in
identification of problems. They should also be progressive, passionate, motivated,
goal oriented, solution-focused and able to affect and provoke the members of the
group (Mahoney, 2001).

A successful and good leader should be able to influence and affect other staff
through their leadership and motivate them to apply what they learn, try new skills,
develop themselves and be competitive while supporting them. Every individual in a
group should be recognized their unique needs, not everyone can respond and perform
very well in the same way to the workplace. A good leader should always motivate
and inspire staff in such a way the workplace can achieve its goals.

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Leadership Challenges in Healthcare

The healthcare system can be as strong as it gets. The only constant thing in this
world is change. Here in New Zealand, healthcare is very important. Improvements
are greatly made by the government to meet the needs of the people living here. There
has been a vast change and development in the leadership systems and processes
within healthcare. Leadership is more likely viewed as and industry wherein it is
facilitated by beyond the administrative hierarchy. One of the most critical and
important responsibility of leaders is leading change. Leadership is an essential area
for development. In order to survive, private and public healthcare sectors needed to
change the way things were done before. A major change in the healthcare
organisations can be initiated by any member and contribute to its success but it will
always be mandated by the top management team. If a leader understands the reason
why the team resists or adapts change, the efforts to implement change in the
healthcare organization is more likely to be successful (Hewison & Griffiths, 2004).

The disempowerment of the nursing profession has been taken into consideration in
the implementation of clinical governance and leadership. If nursing gains the respect
of other allied health professionals, there will be a change in the outcome of
delivering care (McKenna, Keeney, & Bradley, 2004). According to Degeling P and
Carr A (2004), different allied health proffesionals rejected systemisation of clinical
initiatives and teamwork and were all skeptical about it. Attitudes towards healthcare
reforms found variations by their professional backgrounds (Degeling & Carr, 2004).
A recent study at National Health System about physician leaders who were working
with managers over the past five years says that there were high number of conflicts
over achieving goals rather than relationship improvements and finding solution to
problems (Reasbeck, 2008). It all goes down to physician autonomy that complicates
the quality improvement initiatives not unless clinical leadership is protected by the
administration, changes will definitely can happen (Tuoati, Roberge, Cazale, Pineault,
Tremblay, & Denis, 2006).

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The number one financial challenge and concern of New Zealand’s healthcare system
is the fast growing demand for patient safety and healthcare outcome improvements.
Healthcare is a business. Improvement of service, assimilation and modernization in
healthcare should be transparent and constantacross the world. The real questions
remains, how do we make that change that will respect healthcare systems and
explores leadership as a process shared among allied health profession and non allied
health professionals? Fundamentally, until allied health professionals and non allied
health professionals work together in solving the issues, there will be an effective
change.

All organizations learn things but some do it much better than the others and some do
not. As Task Group (2009) said about New Zealand in transforming clinical
governance, “Healthcare that has competent, diffuse, transformational, shared
leadership is safe, effective, resource efficient and economical.” Many allied health
care professionals felt that they were not able to influence decisions on healthcare
delivery while being accountable for the results of the decisions made by managers,
or at least responsible for such outcomes. Some decided to retract the responsibility
given and just do their own thing without thinking of the possible outcomes. As
managers make decisions without the knowledge and expertise, feel less influential to
the allied health professionals who deliver and determine the quality, cost and safety
of care.

In order to improve the quality of care in health and disability services, “In Good
Hands” report was made that defines clinical governance developed for greater
engagement in clinical care. It is a report the discusses leadership that can identify
and measures performance, structures within District Health Boards (DHBs) in order
to achieve better healthcare quality and safety, reporting of outcomes, trainings and
success sharing. The system is called Clinical governance while leadership is a
component of the system. It is the responsibility of the system to improve the quality
of the services and always assure high standards of care by creating a healthy
environment (Scally & Donaldson, 1998).

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Literature Review: Leadership Theories and Models

Cultural Leadership

Great Man Theory: This theory assumes that the capacity for leadership can be
inherited, that leaders are born, not made. This has been one of the oldest theories
about leadership. Charisma, wisdom, and intelligence are the attributes that are used
by this theory. Leaders are portrayed as heroic, mythic and destined. They lead
through their personal attributes, such as charisma, intelligence and wisdom. It was
called great man theory simply because it is an old theory pertaining to male qualities
such as military leadership.

Trait Theory: Developed in the early 20th century, similar to great man theory, it
states that some people possess skills and traits of being a leader that cannot be learnt.
Many begun to question this theory, how to explain those people who can possess
those attributes but arte not leaders? There have been inconsistencies in traits and
effectiveness that led scholars to shift in find explanations.

Behavioral Theory: In contrary to Great Man theory and Trait theory, this theory
states that great leaders are made, not born. It was discovered in 1960s, focusing on
the actions of leaders rather than the traits. Training and observation can be learned in
order to become a leader. According to Naylor (1999), there are two types of
behavioral theory, autocratic and democratic. Autocratic leaders works as long as
there is a leader who mandates. Democratic leaders allow members to do their thing
even on the presence or absence of leaders.

Contingency Theory: According to this theory effective leaders develop unique ways
of working with their followers depending on the situation and the needs and
attributes of followers.

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Transformational Leadership

Relationship Leadership is another term for Transformational Leadership. This

leadership focuses on how to achieve the goals of the work of the leaders by
motivating, guiding and directing members. This kind of leadership brings out
employees’ dedication to achieving the goal (Sullivan & Decker, 2004).
Transformational leadership is encouraging, engaging and working together to
achieve a common goal (Kelly-Hiedenthal, 2004). According to Roussel, Russel and
Swansburg (2006), management of trust, meaning, self and attention are the four
components of effective and dynamic leadership. In these, there is a great need to
create connection by which a person can participate with others and build teamwork
that can boost the morality and can result to high motivation in both the leader and the
followers. These kinds of leaders are focused mainly on the performance of each
member particularly in building potentials. Judgement from this kind of leader is
consistent. A healthcare organization can be defined by how they serve the
community and whether they achieve their visions and goals. In order to achieve the
attention of the management an organization should have goals and visions. The skills
of every individual staff and the knowledge on how to utilise properly and effectively
can define the meaning of self. There must be always a commitment leaders must
always encourage its followers by having group discussions, agreements, meetings
and team buildings in orders to bring the organisation as one. There must be training
ad continuous education for leaders in order to develop and enhance their leadership
and management skills.

In order for transformational leaders to be effective, followers must be able to trust

them. It is said that this theory can be used in hospitals simply because hospitals are
unstable and its environment is rapidly changing. Therefore, leaders in hospitals
should be flexible, motivated, acknowledge faults and uncertainties, and most
especially consider the employees’ needs (Roussel & Russell, 2009). Involvement of
staff members in decision-making can make the feel that they are part of the
organisation’s success and they can be motivated and inspired to work. Rewards,
remuneration, acknowledgements and certification are different ways that can be used
by the leaders to inspire the staff for their excellent job carried out and this can also
build great relationship between leaders and followers.

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Contemporary Leadership Models in Healthcare

Clinical Nursing Leadership Learning and Action Process (CLINLAP) model/

Leadership Learning and Action Process (LEADLAP) model

CLINLAP/LEADLAP was developed to address the constant changes within the

healthcare environment. The focus of these models is the learning and leading
aspects for the workplace. The CLINLAP can enhance the ability to connect
theoretical aspects with practical aspects that can promote learning even when
working. CLINLAP, a 15-month Action Research Project that was discovered in 1997
by Jumaa tried to discover what skills, knowledge and attitudes are required to
perform the job effectively. In summary, CLINLAP found out that the general main
problems of leaders are clinical goals, roles, processes and relationships and having
an open relationship, clear visions, goals, and roles can lead to solving these
problems. In CLINLAP model, strategic learning is used. Complex issues and issues
are usually resolved by this model.

There are advantages and disadvantages of this model. The most significant
advantages of CLINLAP/LEADLAP model are: it develops and sustains high
standard performance, develops and enhances the knowledge of allied health
professionals that relates theory with practice, assisting other staff to facilitate proper
care and process, promotions, flexibility, developments, and having structure from the
past and future (Jumaa M. , 2001). There are also disadvantages of
CLINLAP/LEADLAP model includes: lack of accessibility, a great need of
knowledge and leadership, not as “quick-fix” for change and improvements, requires
continuous support and investment in order to sustain learning and it is life-long and
requires CPD (Alleyne, 2002).

This model provides a structure for such developments that needs to be achieved.
There is a great need of efficient management and effective leadership to sustain the
success of CLINLAP/LEADLAP model. Satisfaction is only possible through
collaboration amongst all allied health professionals in the healthcare organisation
(Jumaa & Alleyne, 2001).

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Group Leadership Skills

Group Leadership skills are important in planning because one cannot be

accomplished without teamwork and cooperation of group members. One must learn
on how to work effectively with other people. It is important simply because effective
group skills can help make the workplace easier and healthy. This Leadership is
important from the day a person is born. It is first witnessed in the family where
socialization takes place. Then, friends, social community, work groups, religious
groups, and other groups that a person is involved become an instrument for learning
and obtaining goals.

Group leadership skills help form and lead different kinds of groups. One may not
always be a leader but one can always share insights to one another and build
decisions as one group. Building trust is one of the key elements in building a
relationship upon the group. A group is a system wherein members are the
identifiable parts that influence each other and as a whole called group.

There are three different types of group leadership skills: task, teaching and
supportive/therapeutic groups. The primary purpose of task groups is to accomplish a
given task and given the highest priority on decision-making and problem solving.
This type of group is often formed to solve a problem and usually under pressure to
complete a task in a certain period of time. Teaching group’s primary purpose is to
impart information. A person can always learn from somebody else. In hospitals,
seminars and trainings are given to impart additional learning to the staff and to be
able for them to share the knowledge to other people. The supportive/therapeutic
group’s primary purpose is to deal with the emotional stress in the healthcare settings.
The focus of these groups is to examine feelings, thoughts and behaviors of members.
It also focuses on preventing future problems and upsets in a way to help members to
teach them on how to deal with stress if a situation arises and how to cope with the
situation in the easiest and best manner.

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A Group leader should be a model to the members. Having high tolerance for
frustration, anxiety and disorganization is a must for a group leader. A group leader
must be willing to accept criticisms and suggestions from the members in order to
have healthy environment. A good leader is also a good listener. A quick response to
a problem and message should be an ability of a good group leader. A great sense of
humor also an asset of a group leader. Despite pressure, problems and tasks to be
given, a group leader should always know on how to handle the group properly and
keep the members motivated and willing to participate ad can decrease the tension
and pressure to the members.

To be an effective group leader takes courage, knowledge and skills. Being a group
leader requires more energy and a greater responsibility to the group and to the
organisation. You are the core responsible to whatever happens to your group. All
members should share knowledge to each other to become an effective group. AS
leader, teach the group to be effective and participate in decisions in accordance to
their ability and skills. No criticisms should be made thus fair and equality should
always be practiced.

Ineffective group is obvious when there is seniority and authority. Inequality,

authoritarian members and domination in making decision make the group
ineffective. Group members will not learn and there will be less motivation and
effectiveness upon the group.

If given a group is given a task, it should be clarified, flexible to anything to meet the
goals of the group, promotes cooperation, protection, trust and support, encourage
criticisms, taking responsibilities, solve problems and evaluate outcomes.

Leadership in groups is helpful in examining the process that determines team

performance. Leaders can improve the performance of the groups by influencing the
process in a positive way. Group performance will be perfect if all the members are
motivated and share the same objective. An important leadership role in teams is to
always ensure that the members are committed and willing to exert efforts to carry out
successful outcomes (Yuki, 1998).

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Emotional Intelligence

In order for a human to survive, emotional intelligence is great factor and aspect of
intelligence that is required to be achieved. It is an important factor for everybody to
understand and embrace. Healthcare leaders are encouraged to be aware of the
emotional factors of the group and its members. There are four domains of Emotional
Intelligence: Self-awareness, Social awareness, Self-management and Relationship
Managements. In self-awareness, it is important to have self-confidence and
emotional and accurate self-assessment. Empathy, organizational awareness and
service orientation comprises social awareness. Then, in self-management, a person
should have emotional self-control, give transparency, adapt to change, initiative and
be optimistic. Lastly, Relation management is to inspire, influence and develop others
and most especially to build teamwork and collaboration within the group and the
organization (Goleman, Boyatzis, & McKee, 2004).

Emotional intelligence is a factor for critical leadership skill for healthcare leaders. To
obtain leadership, strong associations should exist and building a relationship towards
other members. There are strong connections exists between emotional intelligence
and healthcare leadership effectiveness (Stoller, MD, MS, 2017). It is one such
personal characteristic that is a requirement for all allied health professionals. In order
to be effective in practice and deliver care with respect, emotional intelligence is
suggested. To improve quality of work and increase productivity to the organizational
success, emotional intelligence is attributed. It is also related to job performance and
satisfaction and linked to emotional expressions, mood managements, stress
adaptation and socialization (Birks & Watt, 2007).

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Conclusion

Effective leadership is science and art. Promoting change in this vast changing
environment is the most essential part of leadership. The most important leadership
functions to work as team in an organization are: to help others to get the meaning of
events and understand the importance of it and relevance to opportunities, creating
alignment on goals, strategies, and objectives, build trust and cooperation, strengthen
the group, organize activities, encourage everybody to learn, be just and fair, develop
and encourage people and most especially to promote morality within the group and
organization. People have been interested since the beginning of history about
leadership, and the study of leadership as a discipline in science started since half a
century ago. There have been different types of theories and leadership skills
developed before that created confusion Nevertheless, much still remains to be
learned. Leadership is essential for adapting with the vast growing social and
economic problems throughout the world especially in the health care organisations.
Different concepts and approach about leadership explains different focus but seems
to be similar in many ways.

Leadership can be performed by any member of the group, can be just a member or
the leader, can be elected, appointed, recognized and initiated on the circumstances.
Leadership will always be a subject that will always interest people because of its
wide functions and history and it touches everyone’s life. Mysteries about leadership
are yet to be answered, there are still on-going researches about leadership that is yet
to be discovered. There are different approaches in studying leadership, conceptions
about it and different ways of evaluating leadership’s effectiveness.

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 References

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Saddle River.
Alleyne, J. (2002). Making a Case for Group Clinical Supervision Through
Management and Leadership Concepts. Unpublished Research Project Report,
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learning in clinical nursing leadership.
Birks, Y., & Watt, I. (2007). Emotional intelligence and patient-centered care.
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Porter-O'Grady, T. (2003). A different age group for leadership, part 1. Journal of
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