Building Organizational Capacity

This essay discusses the role of a leader in improving patient waiting time in a clinic and the impact of transformational leadership. It also explores Kotter's Eight Step Model for implementing change in healthcare settings.

Running head: BUILDING ORGANIZATIONAL CAPACITY
Building Organizational Capacity
Name of the Student
Name of the University
Author Note

1BUILDING ORGANIZATIONAL CAPACITY
Introduction
The issue of patient waiting time, in a clinical setting is one of the most common
public issues that is impacting on the patients in a negative way. Therefore, it is reported that,
the prolonged waiting time of the patients is also affecting the issue of patient satisfaction in a
negative manner. So, it can be said that, in order to improve the condition of the patients, the
condition of this patient waiting should be improved. For this improvement of the waiting
time of the patients, change is required. In order to change, this condition a strong leadership
step must be implemented by the leader of the organization (Bleustein et al., 2014). In a
health care setting, the presence of a good quality leader is very useful as an efficient leader
of a team has various traits and those traits of a good leader will help to implement good
changes in the organization. Moreover, a good quality leader has certain qualities that can
influence the employees to implement changes in an organization. With the existing skills of
a leader, he or she will work to develop the skills, capacity and knowledge of other
employees who are facing challenges in their works and it will help those employees to take
part in the overall changing process of that particular organization. Such leadership quality
of a leader will help in gaining positive changes in the organization as well. In addition to
this, presence of a good quality leader in an organization will also motivate the other
employees to work in their full potential as a good leader is aware of the skills and strengths
of the employees and it will help him or her to take advantage of the strengths of that
particular employee in that organization (Martin, 2015) The main aim of this essay is to
investigate the role of a leader in improving the condition of waiting time in a clinic as it has
become one of the major problems for the patients in health care settings. In this essay, the
role of a leader in improving the aforesaid condition, theory of change in the context of health
care sector and effect of performance improvement on individuals and on the organization are
discussed in a brief manner.

2BUILDING ORGANIZATIONAL CAPACITY
Transformational Leadership
From various studies it is reported that, in the outpatient clinic of the hospital settings,
the patient has to wait for a long period of time and this results in various adverse condition
such as impaired access to health care settings, interruption in work pattern of the hospital
settings, patient dissatisfaction. In a study, it is reported that, the patient who visited the
outpatient clinic of a Canadian hospital, spent almost three times more time than that of the
time required for the whole process. On the other hand, in another study, it was reported that
in China, each patient in an outpatient clinic has to wait for almost 98 minutes in an average
to get registered in the treatment process. In addition to this, in Malaysia, this waiting time is
almost more than 2 hours and in the contrary the consultant time of the patient is only 15
minutes (Xie & Or, 2017). So, it can be said that, the waiting time of the patient in a health
care setting should be improved. In order to implement changes in an organization, it is very
crucial to have an efficient leader who can identify the needs of changes in an organization.
As an ideal leader the individual should firstly identify the needs of changes and the
stakeholders related to that changes. It can be said that, the leader may follow the
transformational leadership model as this leadership model helps the leader in building the
team and also making the team flexible so that they can gain the capacity to achieve the
common goal of the organization (Belias, D., & Koustelios, 2014). This transformational
leadership model will help the organization to work towards a better waiting time of the
patients in the clinics (Baesu & Bejinaru, 2014). The term transformational model refers to
the leadership approach that can help in the changing process of an individual or a system.
According to this leadership model, there must be positive changes in the existing process by
the activities of the leaders of an organization. In case of improving the condition of the
health care settings, the application of the transformational leadership model is very effective

3BUILDING ORGANIZATIONAL CAPACITY
as it can address the problems of all the stakeholders as per their needs in the clinical care
settings. Only a good leader can address the problem and take steps towards a positive
changes (Ghasabeh, Soosay & Reaiche, 2015) In order to gain the common goal, the leader
will take required steps as well. In a transformational leadership model, the leader will
create a vision to direct the changes through inspirational behaviour of himself or herself.
This transformational leadership model is very effective in implementing changes in the
health care settings, as there are four factors in the transformational leadership theory that
motivate the stakeholders of the organization to perform in a better way and it will help the
stakeholders to improve the condition in the health care settings as well. A Transformational
leadership can clarify the goal of the organization, take adequate action for achieving the
goals. A leader following the transformational leadership model in the health care setting can
identify the stakeholders who have the capacity to achieve the goals of the organization by
securing the mission of the organization (Stone-Johnson, 2014). In case of a health care
setting, the leader may follow this leadership model for reducing the waiting time in the
clinic. In this process, apart from the leader of the health care organization, the other
members of the health care organization are also responsible for achieving the common goal
set by the leader of the organization. In a transformational leadership model, there are a few
factors that can motivate the other stakeholders of the health care organization to perform in a
well manner. It is the duty of the leader of the organization to motivate the other members to
work and along with this he or she must inspire all the employees to work towards a common
goal of the organization that is reducing the waiting time of the patients in the clinic (Qu,
Janssen & Shi, 2015). In the transformational leadership model, charismatic leadership is one
of the leadership quality through which a leader can earn trust, respect and confidence and
those qualities should be transferred to the other employees of the healthcare settings so that
they also can have motivation to work towards reducing the waiting time of patients in the

4BUILDING ORGANIZATIONAL CAPACITY
clinic. A strong sense of mission and vision can simultaneously help the leader to identify
the required action for addressing the problem of the health care settings (McCleskey, 2014).
However, it is observed that, the waiting time in the health care setting is one of the major
reason for patient dissatisfaction in the health care setting. So, in order to make a change in
this process, the leader has to identify the problem exactly and must find the reason of this
aforesaid problem. As it is collective approach, so the leader must incorporate all other
employees in this process. The next quality of the leader that can motivate employees to work
as a team is the intellectually inspiring quality of the leader. A leader may only be successful
when he or she can intellectually stimulate the employees of the health care sector so that
they can also take part in the process in a positive manner (Lee, 2014). The third quality that
the leader can use during implementing the process that is the self-value process so that each
and every employee of the organization can feel that they are also valued by their leader and
this can again motivate them to show the best effort towards their organization and it will
help the leader to achieve the ultimate goal that is reducing the waiting time of the patients in
the clinic in the health care setting (Effelsberg, Solga & Gurt, 2014). Therefore, if the
employees of health care organization can feel that they are also important for the
organization they will also have their job satisfaction and it will enhance the employee
motivation simultaneously and thereby the task of the leader will be easier (Top, Akdere &
Tarcan, 2015). In addition to this, the leader should deliver motivational speech and should
communicate with the employees in a positive manner. The transformational leader in the
health care setting have the ability to change the mind of their employee from self-serving
behaviour to a good a team member. A leader should act as a role model in such scenario so
that other employees of the organization can have motivation form the leader. The activities
of the leader in the health care settings will stimulate the employees by his or her own work
so the other employees of the organization also can grow an innovative ways and they also

5BUILDING ORGANIZATIONAL CAPACITY
will not afraid of taking any risks and they may take various unconventional steps in order to
improve the condition of the health care settings. In this way a transformational leader in an
organization allow the employees to provide input to the organization’s improvement and it
will help the leader to improve the condition of the health care settings (Long et al., 2014). In
todays, modern health care setting, it is observed that, patients are mostly neglected and in
such condition the transformational model is very much required in order to make the
condition better in terms of patients’ satisfaction. The transformational leadership model
should definitely identify the problem so that he or she can address the problem. In health
care setting, in order to make a change in the health care settings the leader at first should
firstly inform the other employees that the process is not working in a good manner and that
is reason they should go the changes in their existing practice in the health care setting. In the
next step of change the leader must create a vision for the change so that the leader can
provide a clear picture of the changes that is going to be happen as a part of the proposed
change in the organization and it will help the leader to overcome the barriers that may be
faced by him or her during implementing the changes in the health care setting (Martin,
2015). It will help the leader to implement the changes in an easy way. In addition to this, in
the next step, the leader will actually work to change the condition. In this step the leader
may train the employees in the systems and he or she will work to develop the skills of the
employees in the health care setting so that all the employees can effectively contribute in the
process of change. In this stage, the leader of the health care settings can see the actual
changes that is the improvement of the waiting time in the health care setting. Moreover, a
leader in the health care setting will also try to remove the barriers that may be faced by him
or her during the implementation process of change in the health care as by removing the
barriers from the way of implementation, the leader can feel relax as all the employees are
aware of about the changes in the organization. In addition to this, the leader may also face

6BUILDING ORGANIZATIONAL CAPACITY
hindrances from the side of the organization and if the leader lacks a clear vision about the
changes that is going to be happen in the health care setting (Ljungholm, 2014). He may face
less amount of hindrances during the implementation process. The team work behaviour of
the employees in the organization will help to build the process of changing in hustle free -
way. So, it can be said that, the transformational leadership model in the health care setting is
very critical to implement a change. Although, with a good team building capacity and good
team work the leader can implement the changes in the health care settings (Feng, Huang &
Zhang, 2016)
Kotter’s Eight step Model
For addressing the changes in the health care setting, Kotter’s Eight step model of
changes can be implemented as in modern health care sector the change is required for
improving the waiting time of the patients in the clinic. According to the Kotter’s Eight step
model there are eight steps in the overall change process within an organization. The steps of
this model are sense of urgency in the organization that is health care setting, establishment
of a specific group of people who will be engaged for the change process, defining a
particular goal, sharing of end goal, encourage the participation of the employees in the
whole process, defining short term goals, stick to the change in the organization and
connecting of the changes to the cultures of the company (Pollack & Pollack, 2015). As a
part of the first step of this model, to create a sense of urgency in the organization, the need
for the changes should be identified. According to the study of Mohebbifar et al. (2014), it is
reported that, one of the major concerns of the patients in the health care setting is the longer
waiting time due to lack of time management and this is affecting the issue of patient
dissatisfaction as well. This study reported that, the average waiting time in the out-patient
department is almost 245 minutes. So it can be said that in order to improve the patient
outcome and patient satisfaction, this change is very much required. After identifying the

7BUILDING ORGANIZATIONAL CAPACITY
needs of changes, the leader must build a team to implement this change process as a part of
the second step of Kotter’s eight step model. Moreover, the leader must have a clear vision
regarding the changes in the health care setting so that each and every employee of the health
care setting can understand the end goal and it will encourage them to participate in this
process and it is quite evident that, without the help of the other employees, the leader cannot
implement the change to the existing system (Ghasabeh, Soosay & Reaiche, 2015). For
implementing any changes in the health care setting, the work place culture is very crucial.
In an ideal work place culture there must be a few characteristics such as respect to the
employees, teamwork, engagement of the employees, responsibility of the employees.
However, lack of such characteristics in the work place can help the changes to implement in
the work places. According to the study of Hoch and Kozlowski (2014), it is reported that ,
teamwork in a health care setting has helped to implement the changes. On the other hand the
study of Holten and Brenner (2015), supported the importance of employee engagement in
the change process of an organization. In case of a health care organization, it may be said
that this process is same as well. Presence of such qualities in a health care setting can
support the changes in a health care settings. The study of Salas et al. (2015), showed that,
the lack of team work in clinical care setting has promote the failure of changes in the
organization. A leader in the organization must handle the changes during the
implementation process. According to the study of Tappen et al. (2017), the primary barriers
of implementing changes in an organization are stakeholder resistance, scarce resources,
technical problems, instability of facility leadership, magnitude and complexity of the
change. On the other hand, there are a few facilitating factors, that can promote the changes
in an organization, are adequate training, leadership support, involvement of the organization,
use of administrative authority and releasing the positive short outcome. In such condition
the leader of the organization will promote the facilitating factors to achieve the goal and

8BUILDING ORGANIZATIONAL CAPACITY
simultaneously the leader must try to minimize the barriers in the way of implementation.
Moreover, the management, should support the changes which are implemented in order to
improve the situation as part of the last step of Kotter’s Eight steps of change. The leader
must set an example to the other employees so that they are motivated about the
implementation process. In multiple studies, it is reported that, the a good practice by the
leader of an organization can motivate the employees of that organization to perform in a
well manner. According to the study of Ellis et al. (2014), it is reported that, the success of a
person in an organization can motivate other employees in that organization to perform
better. So it can be said that, it is very important for the leader to set a good example of high
quality performance so that all the other employee can have motivation.
For motivating and engaging the staff in the change process, the leader of the
organization may take opinions from the stakeholders so that they can feel that they also have
importance in this whole process and the leader should not take any decision alone, rather he
or she should take any decision collectively in all the steps of the change process. After
implementing the changes, the staff should be asked about the positive and negative points of
the implemented changes and this will allow the staff to engage in the whole process (Benn,
Edwards, & Williams, 2014).
Conclusion
Hence, it can be concluded that, the in a health care setting it is very crucial to reduce
the waiting time for the changes so that the issue of patient satisfaction can be improved. In
order to take a step towards a major changes in the health care setting, the leader of the
organization must take an appreciable step with a clear vision so that the changing process
can be smooth. However, it is not possible that, there will be no barrier in the way of
implementing a change in the health care settings. Hence, it is the duty of the leader to

9BUILDING ORGANIZATIONAL CAPACITY
manage those barriers and simultaneously motivate the stakeholders to take part in this
changing process and it will help the leader in improving the condition.

10BUILDING ORGANIZATIONAL CAPACITY
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