Health Care Leadership and Change Management

This paper discusses the role of healthcare leadership in facilitating change and performance improvement in a healthcare facility setting. It emphasizes the importance of building a favorable workplace culture, effective communication, and the use of change theories to achieve performance improvement. The paper also discusses different leadership styles that can be used to facilitate change and improve performance.

Running Head: HEALTH CARE LEADERSHIP AND CHANGE MANAGEMENT 1
Health Care Leadership and Change Management
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Health Care Leadership and Change Management
For any organization to experience improvement in its productivity and overall
performance through time, then the facets informing change and performance improvement are
very critical (Choi, and Ruona, 2011). However, implementing change and performance
improvement especially in the healthcare setting is quite difficult. This is because most
healthcare practitioners view their profession as having two edges; a vocation as well as a
profession. Moreover, most of these employees are in most of the time suspicious of the action of
the healthcare administration besides being resistive to crucial changes impacting healthcare
provision. While the top management may be desperate for change and overall organizational
performance improvement, the staff can view such changes as exploitative in adding on their
roles and responsibilities (Weberg, 2010). To this end, there is a need for healthcare management
leadership to institute a working organizational culture that has the abilities to let employees
embrace changes to healthcare practice. This calls for the need to remove any barriers hindering
change implementation, promotion of effective communication throughout the healthcare
facility, staff capacity building and adopting relevant leadership skills in effecting the same. This
paper will extrapolate on the role that healthcare leadership plays in facilitating change in a
healthcare facility setting.
Change management has received many definitions over the last several decades. A
succinct definition relates to change management to the exhaustive process of availing new ways
of thinking and doing things among a particular group of people. Change management is
instrumental in elevating organizational effectiveness and performance improvement.
Organizational changes are for the specific reason for the desire to achieve specific desired future
outcomes. In a healthcare setting, this may connote to the general improvement in the way of

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handling health records, providing better healthcare to patients, reduction of redundancies in
healthcare supply chain management among other objectives. Healthcare leadership must aim at
planning and advocate for change at the individual healthcare employee level to facilitate overall
organizational change embracement (Al-Sawai, 2013). The leaders must take change
management as an enabling framework and an opportunity for managing the people side of
change. This goes a long way in counteracting resistance to change besides increasing the speed
for change adoption of the same among employees.
An important facet in effecting change management and performance improvement lies
with the realization of the influence healthcare leaders can have on their subordinates. The
adoption of healthy leadership theories, strategies, leadership characteristics, and styles can go a
long way to this end. Leadership refers to the general behavior of a person when given the
opportunity of directing the achievement of shared goals and objectives (Sullivan, and Garland,
2010). The primary role of leaders is to influence and steer organizational activities and coping
with any imminent changes that may emanate from internal operations or external pressures. A
setback in the consideration of leadership styles in the healthcare sector is the fact that most
change and leadership theories were advanced for the business.
However, healthcare professionals have endeavored to customize them to fit for the needs
of healthcare. Leadership like change is dynamic and therefore healthcare leaders ought to
acquaint themselves with the latest facets informing efficient leadership (Curtis, de Vries, and
Sheerin, 2011). Although the Great Man Theory is of the assumption that only particular people
are endowed with leadership skills, several behavioral theories have been advanced in the last
several decades indicating any one individual can be an influencing leader. These include
authorization, laissez-fair, democratic, contingency, situational and interactional leadership style

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theories. Depending on which leadership styles leaders take in their leadership role, they have
abilities influencing their juniors either positively or negatively with regard to changes and
performance improvement.
For a long time, interactional leadership has been labeled as an important leadership style
in the healthcare sector with abilities to create positive workplace environment besides nurturing
organizational cultures. Interactional leadership lays emphasis on influencing and shaping a
particular organizational environment by promoting positive relations between leaders and their
followers. The aim is to create a harmonious work place environment in which all parties feel
part and parcel of the organization. Interactional leadership by and large promote the facets
informing supportive leadership. Proponents of this school of thought assert that supporting and
forging productive relationships with staff alleviates the possibility of influencing the positively
besides being motivated to work towards achieving organizational goals. Overly, interactional
leadership theories are founded on the premise that individuals tend to be happier and satisfied
while at work when they are in the company of supportive leaders who empathize at the
employee’s personal level.
It is important to note that healthcare systems are made up of a multiplicity of healthcare
professionals groups, specialties, and departments with complex interactions amongst them. The
complexity of these interactions is compounded by the constraints advanced by the different
disease areas; multisectional and multidirectional goals and multidisciplinary staffing
arrangements. Moreover, within this complex healthcare system, numerous sub-organizational
cultures are eminent to arise which might be in support of or in conflict with one another.
Fronting organizational change and performance improvement in such a set-up is quite a huddle
for health care organizational leaders. To this end, leadership should be tailored to capitalize and

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take the diversity opportunity presented by the system to efficiently utilize resources when
planning for organizational changes and management processes (Anderson, and Anderson,
2010).
In a fast changing global environment, people have increasingly become more informed
of their fundamental freedoms and human rights and therefore approaching them for change
purposes ought to be done with utmost care. Transformational leadership is such one instrument
that can be exploited to this end Salanova et al. (2011) observe that transformational leadership
advocates for a shared responsibility between the senior management and the staff in effecting
organizational objectives and goals. To this end, employees are actively involved in giving the
opinion on what is supposed to be the ideal situation for various concerns. Transformational
leaders are also bound to embrace hands off, charismatic and transitional leadership as opposed
to the transactional leadership that only focus on employee supervision and group performance.
The style advances that employees ought to be involved throughout the change process from the
very planning to evaluation and monitoring.
This approach counteracts the resistance that can emanate from a dictatorial leadership
style in which employees are only spelled on what do at the implementation stage. Healthcare
leaders ought to embrace the virtues of respect, integrity, empathy, and recognition of the
abilities that others hold in shaping the overall organizational change. This by and large assists to
mold the positive culture of the health facility. Employees feel wanted, motivated and
encouraged to achieve more for the organization. In building the culture of the healthcare
facility, transformational theory stresses the significance of sharing the mission of the facility
with the employees through proper communication channels. In doing so the leadership is able to

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thwart any resistance when it comes to effecting organizational changes or improving the
performance of the already available policies (Fugate, Prussia, and Kinicki, 2012).
Leaders should use powers conferred to them advance to build the capacity of their
employees. Transformative leadership gives emphasis to effective communication of the leader’s
vision of the organization to their juniors (Weberg, 2010). This should be done in a way that
employees are able to perceive meaning besides being exiting and able to create harmony and
collectivity of purpose. The leader who has a vision and is generally able to influence and
empower others can be termed as a transformative leader. Change management and performance
improvement ride on this yardstick since the leader is in a position to motivate performance and
infiltrate change facets upon employees.
Another important leadership style that plays a significant role in facilitating change and
performance improvement is collaborative leadership. Collaborative leadership refers to the
assertive and cooperative engagement of employees in work for the mutual advantage of both the
organization and employee’s themselves. This symbiosis association allows the management to
communicate important information to employees to enable them to make informed decisions
and choices regarding their work performance. This kind of collaborative communication
enables healthcare management to capacity build their staff since it encourages a productive
dialogue between multidisciplinary stakeholders on the facility’s best causes of action. It is on
such a platform that changes management and performance improvement concerns ought to
exploit in order to smoothly trickle down important changes in healthcare strategies, policies,
programs, and methodologies (Annandale, and Witz, 2013).
Employees are in a position to share knowledge, skills, experience and best practices
effectively decreasing the complexity of the healthcare system. Employees engaged with

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different roles and responsibilities need to tap from the leadership in a bid to give their opinion
concerning changing healthcare demands. In further building employee’s capacity (Peirson, et al.
2012) observes that collaborative healthcare leadership demands a synergistic work place culture
in which collective efforts are central in effecting planned changes and improving the
performance of already existing programs.
A favorable workplace culture has been labeled by change and performance improvement
proponents as an ideal factor in realizing the same. A condusive work environment with a
pleasant culture allows employees to concentrate on the achievement of the set goals and
objectives. Healthcare leaders are obligated to advance their staff with such an environment and
play the critical role of promoting and building on existing organizational culture. When leaders
openly and clearly communicate what their vision and mission are like to the staff, it is easy to
infiltrate new facets of change when they do come up. Changes could emanate from the need to
embrace new technologies and working systems internally or the need to meet conditions set by
the external environments such as compliance with national and international policies.
MacKenzie, Podsakoff, and Podsakoff, (2011) observe that the mare interruption of the
existing way of doing things by changes is bound to have little or no effects on staff attitudes
with an efficient work place culture in place. Work place culture constitutes facets such as stable
mission and vision statements, formidable core values, work place traditions, relations and
attitudes. Leaders must asquint themselves with welcoming traits in leadership in order to
continue being effective influencers and motivators to their staff. This includes being respectful
and empathic to employee’s needs; great integrity; effective communication skills; and
productive personal, interpersonal and public relation skills. Such leaders advance a charismatic
viewpoint to their leadership styles which make them good influencers of change and

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performance improvement initiatives. With a favorable work place culture, organizational
structure is bound to strengthen and strategies put better realized.
Effective communication by itself can go a long way in advancing the changes sort by the
healthcare facility. The institution of effective communication channels between the
management and their staff is one strategy that the management can easily achieve its target
(Leeuwis, and Aarts, 2011). Like has been mentioned, healthcare facilities are very complex
institutions with heavy activities going on in them. To this end, there is a very high likelihood of
there being a breakage of communication in which distorted or malicious information can easily
be distributed. A harmonious system of information distribution within the complexity of the
hospital is a great cure for this likelihood. Good communication networks within the health
facility are also good indicators of a working institution. It is on such a platform that new work
place practices, organizational cultures, strategies, policies, and programs can be effected for
improved organizational performance (Zheng, Yang, and McLean, 2010).
Against such a background, healthcare facilities are in a position to bench mark on new
changes and performance improvement requirements of existing programs and policies. Bench
making provides the management with an opportunity to lay new targets for the organization’s
change outcomes. In doing so, the staff is overly involved in planning and implementation of the
new changes besides allowing them to have an insight of what the eventual outcome of the
change will look like from the beginning. With the acknowledgment that such efforts are bound
to be curtailed by resistance, then benchmarking for the future healthcare requirements is best
conducted through a collaborative approach (Davies, Tremblay, and Edwards, 2010). Like has
been mentioned, this assist to make employees feel as being part and parcel of the change
process as opposed to being sidelining by the senior management.

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Change management and performance improvement are underpinned by change theories
that have been developed by theorist over the last several decades. One such theory was
developed by Kurt Lewin back in the 1940 and is still of great usage in today’s organizational
change endeavors. Lewin’s theory: Unfreeze – Change – Refreeze connotes to the three stages of
change process he perceived organizational change follows. He premised his theory on the
analogy of altering the shape of an ice block through first unfreezing the block to make it
amenable to change, then molding it to the shape one wants before finally refreezing it to an
entirely new shape.
Though this analogy, healthcare leaders can endeavor to influence change at the
workplace through a change process with distinct stages. Leaders can prepare employees to
receive change by making adequate plans of orienting them to a new way of thinking and doing
things. Lewin's model gives change managers an opportunity of not leaping into changes before
making an adequate arrangement of containing the requirements in change. This preparation and
motivation for change relate to the unfreezing stage. Organizational leaders ought to sensitize
staff why change from the current way of doing things is necessary and why they ought to
embrace it when it finally comes (Sutherland, 2013).
The unfreezing stage creates a lot of uncertainties and there is a likelihood of resistance
but at the change stage, these people are more or less ready to relive the uncertainties and
embrace the incoming new ways of doing things. Leaders are obliged to vividly communicate to
organizational stakeholders how the change being sort will be of benefit to both the healthcare
facility and individuals. The healthcare facility is set to refreeze to a new way of operations when
stakeholders have finally accepted the proceeds of change. Refreezing can be characterized by
there being a new organizational chart or new roles and responsibilities have been given.

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John Kotter’s developed the 8-step change model after evaluating changes in over 100
organizations 8-step change model (Kotter, 2012). In his development, Kotter observed that for
organizational change to occur, leaders ought to create a sense of urgency among employees that
achieving a certain objective through a different perspective can be of great benefits. To achieve
the new opportunities, then leaders need to mobilize their employees towards the same by
building formidable coalitions. This can only be done when employees are oriented towards the
same through the institution of productive visions and initiatives which align with the overall
organizational culture and visions. It is upon the leaders to inspire their employees to accept the
new changes through effective communication, and motivation effectively counteracting change
barriers (Baker, et al. 2010).
This actions by and large assist in removing any barriers and resistance to change that
may emanate during the change process. Employees ought to be actively involved in the whole
change management process to allow them to own it. Kotter saw the importance of the
generation of short term wins in the change process as a motivating factor as opposed to having a
rigid long term goal. In managing the changes sort, there is a need for balancing change
management with change leadership. This calls for adequate planning, motivation, and alignment
of employee’s skills and strengths for the eventual change take off (Swanson, et al. 2012).
Change is instituted by properly communicating and connecting employees’ new and changed
attitudes and behaviors’ to organizational success. Healthcare leaders ought to remain transparent
throughout the change process to allow employees to decipher why the change was actually
important and valuable to the organization. This transparency is significant in counteracting
resistance to change.

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In the 1960’s, Kubler-Ross’s change curve received unprecedented recognition as change
model in the 1980s. In the model, Kubler reasoned there are five stages of grief associated with
the process of change. These are denial, anger, depression, bargaining, and acceptance. The
model was formulated to help organizational leaders to empathize with their staff during the
process of change implementation (Kübler-Ross, 2009). On the downside of the change curve,
employees are highly likely to react negatively to the whole change idea are bound to go under
denial, express anger and possibly may become depressed. However, since change is not all that
bad, they will later bargain with themselves to embrace it and eventually accept change.
In the three organizational change models described here, it has been deduced that
organizational leadership is very vital in influencing the successful achievement of change and
performance improvement. Leaders are critical facets in realizing the achievement of laid
organizational objectives and goals and must, therefore, acquaint themselves with the necessary
tools and instrument for the same (Mick, 2015, p.159). These include having abilities to realize
their roles and responsibilities in facilitating change, the assumption of favorable leadership
styles and policies and having modest characters that make them approachable and flexible to
other peoples opinion besides. It is only with these facets that they can effectively influence
change in the organization, build staff capacities for the same, communicate their vision, and
cultivate formidable organizational cultures. Moreover, health care leaders need to draw from the
insights advanced by organizational change models to inform their approach in effecting change
in their health facilities. Performance improvement also needs to draw from these insights for the
betterment of existing policies and strategies (Al-Sawai, 2013).
Healthcare practice changes are always welcome so long as they are geared toward the
improvement of the quality and safety of patients. Besides of being cautious of resistance to

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change which can be mitigated through effective communication, transparency, inclusivity in all
stages of the change process, negotiation and motivation, change process ought to be tailored to
cater for the needs of the local population (Rosenberg and Mosca, 2011). To realize this,
healthcare organizations need to tap from the forces motivating transformation and utilize them
in effecting necessary healthcare changes (Lee et al. 2013).

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