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TABLE OF CONTENT

Titles Page

Introduction 2

Leading and Managing at Emergency Department 2-3

General principle of leadership and Management 3

Leadership method and style 4-8

Conclusions 8

References 9

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Leading and Managing an Emergency Department

Leadership and followership are processes that occur between people. The

leadership is visionaries who help subordinates to plan, lead, control, and organize their

activities. Leadership is an attitude that shows behaviour, not series of skills or tasks.

One of the greatest challenges faced by our profession is to develop the future leaders.

Nowadays, it is hard to find people that have powerful leadership skills as many of them

do not know how to apply the theory and priciples of leadership that they have learnt

and put it into practice. Hence, every organisation requires leadership workers who can

master leadership styles and not only the theories and principles. In this way, it can

produce efficient leaders who capable to manage every circumstance that will lead to

better performance.

As a healthcare provider in public health settings from various department such

as emergency departments and wards, we need to complete managerial jobs in our

departments. This is because of the department's hierarchy of organization that puts the

team leader to follow their manager and at the same time, leading their subordinates to

run the department smoothly.

Being a manager is different from being a leader. This is because leadership and

management are two different concepts. Seow (2013) stated that leaders create

organisational change by communicating visions, motivating, inspiring and empowering

people while managers plan, organise and exert power onto the subordinates to control.

Managers always focus on task completion, whereas a leader always guiding the

people to complete the tasks. Besides, managers always emphasise on present tasks

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while leaders look into the future and vision. Bush, Bell, and Wood (2010) mentioned

that managers use their authority to issue instructions while leaders use persuasions

and motivations to make them follow the instructions. These show a wide gap between

management and leadership skills.

The principle of leaderships are commonly studied the phenomenon. As a leader

we must be technically proficient, know our job and have a solid familiarity with the

task of our different employees. In addition, leader should develop a sense of

responsibilities of workers, which can help to develop good character traits and will help

them carry out their professional responsibilities. Besides that, a leader must ensure

that tasks are understood, supervised, and accomplished. Communication is a key for

leader, that can help communicate effectively. Furthermore , leader must know how to

communicate with not only junior staff, but senior staff and other key people as well to

make sure our worker’s informed. One the other hand, be well versed in basic human

nature and recognize the importance of sincerely caring for workers also a part of

principles for leadership. Then, a good leader must good in problem solving, decision

making, and planning tools. Wisely, during critical subordinates rely on team leader to

make a decision making. Seek for responsibility and take responsibility also importance

for a leader. When things go wrong do not blame others, analyze the situation, instead

take corrective action, and move on to the next challenge. Leaders must be a good role

model for employees. Because employees must not only be told what is expected of

them, but it is the leaders that embodying qualities and ethics.

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In our practice area, there are numerous of methods and styles of leadership

used by all staffs. We use behavioural, trait, situational, motivating, transactional and

transformational theory based on the given circumstances.

Behavioural theory is a concept that monitors the leaders’ behaviour . This theory

can be categorised into three different styles which are democratic, autocratic, and

laissez-faire. Autocratic leadership is an extreme form of transactional leadership, where

leaders have complete power over staff. Staff and team members have little opportunity

to make suggestions, even if these are in the best interest of the team or organization.

In our practice, leaders show autocratic styles occasionally due to some circumstances

which are relevant and acceptable for us. For example, when handling emergency

cases, there is no time for discussion. Therefore, Medical Officer (MO) as a team

leader will make a fast and clear decision because during the critical time, the patient’s

life is the highest priority. Based on Strauss and Mayer (2014), he indicated that

autocratic style might be useful in handling critical situation. Nevertheless, the leader

who made the decision must be responsible for any possible outcomes.

In contrast, democratic leaders make the final decisions, but include team

members in the decision-making process. They encourage creativity, and team

members are often highly engaged in projects and decisions. There are many benefits

of democratic leadership. Team members tend to have high job satisfaction and are

productive because they are more involved. This style also helps develop employees’

skills. In workplaces, leaders use this style when we have monthly meetings. We will

discuss the problems that we encounter and how to find its solution. The advantage of

this style is all the subordinates will be happy and satisfied with the decisions as the

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decisions are made together. However, disagreement of ideas and opinions will make it

difficult to decide the final decision.

Another type of leadership styles is called as laissez-faire. According to Leitch,

Lancefield, and Dawson (2016), laissez-faire leadership may be the best or the worst of

leadership styles. Laissez-faire, this French phrase for “let it be,” when applied to

leadership describes leaders who allow people to work on their own. Laissez-faire

leaders abdicate responsibilities and avoid making decisions, they may give teams

complete freedom to do their work and set their own deadlines. This style of leadership

occurs in workplace when the staffs are assigned to run mentorship program for new-

coming staff and give a Continuous Medical Education (CME) presentation. The

advantage of this style is the subordinates will get opportunities to be more

independent, thus developing their leadership skills to become future leader.

Nonetheless, they might commit mistake if there is no guidance given. Plus, without

monitoring from the superiors, some staffs might take this advantage to skip from

working.

Next, our department also applies Trait Theory of leadership which stresses on

leader’s characteristics such as physiological, demographic background, personality,

including charisma, creativity and flexibility. In practice area, when medical officer asks

for an in charge staff for a particular task, they choose the person by referring to these

criteria if all of the them have the same grade.

In addition, Motivating Theory is also being implemented in this departments.

According to Bush, Bell, and Wood (2010) motivating Theory is described as guiding the

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human behaviour based on value and motivation in order to fulfil their desire and goals.

A good leader will always motivate their followers. It is important for leaders to ensure

their subordinates achieve their personal and professional goals. As an example, our

leader always motivates and guides all the staffs to perform well. An annual

performance evaluation will be conducted and the staff with the best performance will

get cash prizes and certificates. At the same time, the rewards can motivate the staff to

improve their performance or maintain their excellence. This theory can intrinsically

motivate all staffs to show their best in doing their job. In spite of that, it can raise

competition among staff which can make the working environment less harmony.

Other than that, Transformational Theory of leadership is also being applied.

Leitch, Lancefield, and Dawson (2016) specified that transformational leaders always

focus and concern towards their followers’ need and development. This is the most

common theory used by our leaders in workplace. Medical officers as the leader always

encourage and concern about our personal and professional goals. This makes all the

staffs enjoy working together as a team and achieving our goals which is providing the

best quality of services to our patient.

There are some barriers in developing leadership skills in health care staffs’

practice. Strauss and Mayer (2014) indicated that some leaders have bad attitudes and

cannot be a role model to their subordinates. Some of the healthcare staff such as

nurses and Asistance Medical Officer did not have confidence and feel powerless due

to the hierarchical position in the organisation. They have a stigma that only the

superiors have rights, and they must follow without question as they work under their

leader’s order. This mindset prevents teamwork between the leader and the

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subordinates. Consequently, the leaders face difficulty in getting cooperation from the

staffs. Besides, lacks of opportunities for advancement causes impediments to find new

potential leader. Moreover, some of the healthcare staffs only focus on their daily jobs

and did not have a long term vision to develop and move forward. Thus, we need to

overcome all these problems and barriers so as to develop future leadership among

health care staffs.

In order to be an effective leader, according to Seow (2013), one must have a

wide knowledge, good management, communication and teamwork skills, portrays solid

understanding about current problems and have a high level of self-awareness to lead

the whole team and makes changes proactively. Plus, an effective leader must have a

good attitude because everybody hates leaders who are grumpy or have negative

attitudes. A good leader also needs to focus on their employees’ satisfaction by making

the workplace a great place to work. Seow (2013) stated that every staff needs a leader

who is enthusiastic, inspiring and has credibility. Moreover, an effective leader must

show concern for their staff’s needs and objectives so as to ensure that the productivity

is not disrupted. Furthermore, in order to achieve goals in any organisation, especially in

health care, the leaders must know how to motivate their staffs and encourage them to

work together as a team.

Last but not least, in order to improve the clinical leadership in practice, clinical

staffs should be educated by the management regularly. Educational preparation for the

health care staffs about leadership is very important. Some investment has to be made

by our ministry to organise leadership programs as it requires a big amount of money.

Leadership styles should also be introduced into the syllabus since the training time can

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make all the health care staffs have better understanding about leadership. Apart from

that, mentoring program for the new staffs is a good platform for healthcare staff to

show their leadership skills. Hence, the selection of the mentor for the mentorship

program should have a rotation so that everyone will get opportunities to improve their

leadership skills. In addition, the leaders in the clinic can involve their subordinates in

daily practice and decision-making process. In this way, they might find better ideas or

solutions by giving the subordinated to voice out their opinions.

In conclusion, leaders are very important in any organisation. Leadership in

health care practice prioritises on being a role model to others, shows good qualities of

leader, have high integrity and impressive communication skills. We also must use the

most suitable leadership styles in order to become a successful leader. By

implementing the principles and leadership styles into practice, we can reflect on our

leadership styles and identify the strengths and weaknesses in order to make

improvement. Not to mention, we need to overcome the barriers in developing

leadership skills. In this manner, we can develop effective leaders and produce future

leaders. Improvement in leadership skills is essential to produce effective leaders that

will serve as an asset to the organisation and help us in achieving our main goal which

is to provide better quality of services in the health care. As a result, it will benefit both

the healthcare staffs and our patients.

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REFERENCES

Bush, T., Bell, L. and Wood, D.M., (2010). The principles of educational leadership and

management. (2nd. Ed). SAGE publication Ltd. London, 1-12.

Leitch, J., Lancefield, D. and Dawson, M., (2016). 10 priciples of strategic leadership.

Strategy & Bussiness 84. Retrieved 23 March 2018, from http://www.strategy-

business.com/article/10-principles-of-strategic-leadership.

Seow, E. (2013). Leading and managing an emergency department-A personal view.

Journal of Acute Medicine, Singapore, 61-66.

Strauss, R.W. and Mayer, T.A., (2014). Emergency department management. China:

Mc Graw Hill Education. 1-116.