Leadership in Clinical Practice: Lowering Patient Waiting Time in XYZ Hospital

This essay discusses the issue of long patient waiting time in the accident and emergency department of XYZ Hospital. It highlights the barriers faced by the leaders of the hospital and suggests various leadership approaches that can be used to bring the required change. The essay concludes with the key findings.

Leadership in Clinical Practice

Contents
Introduction................................................................................................................................3
Discussion..................................................................................................................................3
Conclusions................................................................................................................................8
References..................................................................................................................................9

Introduction
The long waiting time especially in the accident and emergency department is one of the
crucial issues that XYZ hospital (name changed to maintain privacy) has been facing since
long time. The patient waiting time in the A&E departments are perceived as a barometer for
gaining the understanding of the performance of a healthcare organisation. So it is important
that leaders of the XYZ hospital adopt required leadership approach and skills to lower the
patient waiting time. So, it is essential that the healthcare organisation works towards
lowering the patient waiting time in order to improve its performance and enhance patient’s
experience. The leaders XYZ facility needs to adopt the appropriate leadership attributes and
approaches in order to manage the staff and bring this change. This essay describes the
different aspect of the patient waiting time and the reasons for reducing it. The essay further
discusses the barriers faced by the leaders of XYZ organisation to tackle this issue of waiting
time. Next, the essay outlines the various leadership approaches that can be used by its
leaders in order to bring this change. Lastly, the report is concluded with the key findings.
Discussion
Several studies and surveys suggest that the organisations which are unable to tackle the
waiting time frustrations may drop their patient base up to 54% base in a year (Hedges).
Apart from that the organisation may also lose patients who ignore the facility after being
informed about long wait times through various sources like family, web reviews, etc.
Therefore, this change of lowering the patient waiting time is essential or it will affect the
retention, experience and satisfaction of the patients in the XYZ facility. It is also observed
that people discourage other people when they had to experience long wait times. Also, while
searching for healthcare organisations for getting services, people especially hunt for

information regarding waiting times. The patient waiting times especially in A&E department
is affected by the changes in activities and burdens in other services such as the ambulance
service, primary care, social cares, etc. One of the most significant barriers that need the
attention of the leaders is that the conditions should be in favour of the change in XYZ, if the
change implementation needs to be effective and be maintained.
The leaders of XYZ hospital should determine and formulate a well-defined goal and vision
of the change that they want to bring in the facility. As per the McKinsey 7-S model, it is
vital that the shared goal relates with the people and the vision of the XYZ facility of
delivering care and improving service-user’s quality of life (Jurevicius, 2018). The leaders of
the XYZ facility face specific challenges while attempting to handle the issue of patient waits
time like full hospital, higher rates of bed occupancy, mismanaged coordination and
inadequate human resources. People management is significant in the XYZ hospital through
skilful leadership is essential for its efficient functioning. According to Gunderman, it is
important that leaders working in the healthcare facilities should understand the character of
the healthcare organization. The XYZ facility’s leaders must work in coordination with
doctors, nurses, technicians, managers and other professionals. The healthcare leaders must
use the approach of motivation to enhance their performance in the Accidents and Emergency
department to achieve the recommended waiting time. So, the overall functioning of the XYZ
facility is affected by the behaviour and attributes of its leaders. The healthcare leaders can
implement various reward system such as increased income, recognition in public or
punishment system such as warning of termination and cut down in incentive. The leaders in
the XYZ hospital can bring the required change either by firm control or by raising the
autonomy and empowerment.

Various leadership theories can be implemented by the leaders of the XYZ facility for
providing care services in the A &E department to lower the waiting time. They can make
use of transformational leadership. According to the transformational leadership, the task is
done by engaging in the manner in which the leaders and employees elevate each other to
progress by using the approach of motivation and integrity. The leaders of the XYZ hospital
should motivate the staff by transcending their own self-interests, understanding the needs of
the staff and making it in line with the vision of the bigger picture of the XYZ. The leaders
must be able to transform the entire staff while implementing this change to accomplish the
objective of reduced patient waiting time in the A&E department. The transformational
leaders must have the skills and attributes of confidence, visionary, self-awareness to break
the standard professional protocols to construct an interdisciplinary team for service
provision to the victims of accidents or other emergencies quickly. The leaders must practice
a culture in which new and innovative ideas are appreciated to handle an issue. Leadership
includes combining, appraising and contract-based activities which enables the distribution of
power to cultivate interpersonal skills. The leaders of the XYZ facility must acknowledge
other people while planning and providing the services. They should foster a challenging and
stimulating work culture so that innovative ideas are searched to bring this change
successfully. The leaders should work towards building trust between them and the staff to
promote enablement. When these transformational activities are adopted by the leaders of the
XYZ facility then they will get assistance in facilitating the staff in encouraging
empowerment and accountability in order to fight the barriers and resolve the issue of waiting
times. The leaders should not only focus on the behaviour modification of the employees
while implementing this change but also on considerable changes in the standards of the
practice at the XYZ. This style of leadership further demands the attributes of integrity and
honesty by the leaders to strengthen the basic values of moral and ethics. Also, the leaders

should practice openness and honesty in the communication system. They can make use of
their own individual traits such charisma, manipulating skills, etc. to understand and develop
required insights. Leaders must be open to feedback and should be able to communicate their
ideas with clearly and elaborately. They should also have the ability to foresee the potential
consequences of the implemented ideas to bring the change (Cherry, 2018).
Another theory that can be used by the healthcare leaders is the Trait leadership theory. This
theory suggests that specific people have innate leadership quality. Evidences gathered to
determine the specific characteristics of the successful leaders develop a substantial
relationship between effective leadership and traits such as Intelligence, self-confidence,
knowledge, managerial capacity and morality. One profile was suggested by Bass which
outlined the different personal characteristics of the effective leaders and it was categorised in
three basic categories. The first category was of intelligence and included traits like
judgement, decisiveness, knowledge and fluency. Second classification was of personality
and involved compliance, attentiveness, integrity and nonconformity. The last classification
was of ability and it comprised of characteristics like such as coordination, popularity and
tact. The XYZ facility must understand that their leaders’ performance can be improved by
giving training to develop, practice and perfect the leadership skills. XYZ should avoid
waiting for the leaders to come on their own. It must cultivate their own leaders by
identifying the workers who have knack of being good leaders to bring and manage this
change (DERUE, NAHRGANG, WELLMAN, & HUMPHREY, 2011).
Another approach that can be adopted by the leaders of the XYZ facility is the distributed
leadership. This leadership style focuses on the structured outlook which perceives the
leadership as a collective social activity which creates the relations of several factors instead
of the individual characteristics and behaviour of leaders. This leadership style is specifically

valuable to bring the change in patient waiting time at the XYZ facility as the leadership
responsibilities are allocated among the workers across the XYZ hospital (Farzipour, 2016).
The leaders at the XYZ facility can build efficient decision systems by adopting this approach
as the leadership issues cannot be managed by a single leader because of inadequate and
appropriate information with him/her. so, this leadership style will increase the autonomy of
the staff and empower them to take on the leadership roles and work in collaboration to
construct a team which aims at reducing the patient waiting times. Evidence support that
distributed leadership and partnership working together can bring various changes in the
healthcare system including the improvement in waiting times of the patient (Boak, Dickens,
Newson, & Brown, 2015).
Apart from these different leadership styles, Kübler-Ross’ change curve can be used to
handle the emotional and confused responses of the employees regarding the desired change
(Mulholland, 2017). The leaders must understand that they can only implement a change
within realistic deadlines with respect to managing the financial and operational obligations
of the XYZ (Matthew Honeyman, 2016). All the changes need time to be implemented and it
can only be managed successfully when it is executed properly. The existing manners of
functioning in the XYZ will be hard to change and it will obstruct the smooth change of
lowering the patient waiting time. So, the leaders must be able to formulate SMART goals
within realistic deadlines. The leaders of the XYZ facility should focus on the behaviour of
care providers and the requirements of the patients like the Kotter’s theory emphasises more
on the people behind the change rather than the change itself (Selwyn, 2011).
The leaders must adopt the evidence-based methodologies to make sure that the change in
patient waiting time is brought in the planned way. Efficient change management by the
leaders at the XYZ will assist the staff in transitioning to a new way of thinking, behaving

and working as smoothly as possible. The leaders must ensure that the change becomes the
new normal. The leaders should formulate the solutions to the patient waiting time in a way
that the behavioural change required in the employees is inherent in the solution process so
that likelihood of successful change enhances. The XYZ leaders can perform regular
assessments like a change impact assessment to formulate an outline for the detailed strategy
of change the logically manages the requirements of all the stakeholders that are influenced
by the change. The leaders can also conduct stakeholder analysis. They should formulate the
guidelines for new functioning which will involve the defining of new roles and
responsibilities, new incentives, new activities, communication, and training. Training and
support for service user while implementing the change and certain investigations and
evaluation to analyse the efficiency of the change are vital (O’Hanlon, 2016). The XYZ
hospital should be able to develop confidence and expertise of leaders throughout the
hierarchy.
Conclusions
The XYZ was facing the issue of long patient waiting time especially in the accident and
emergency department which was a source of the frustration, poor experience and poor health
outcomes of the patient along with the reduced patient base for the XYZ. The leaders at the
XYZ facility face several various barriers while making efforts to change the patient waiting
time. They can manage the issue of patient waiting time by using the appropriate leadership
style. The utilisation of the suitable and effective leadership style according to the
requirement of the issue will change the scenario and facilitate the management of the issue.
The leaders must develop multiple attributes like motivation, communication, goal formation,
etc. to bring the required change in patient waiting time. The leaders should have the required
skills to develop a trusting relationship with the employees to make the functioning of the

XYZ hospital smooth. The employees should be encouraged by the leaders to enhance their
performance in the A&E department with the help of attributes like openness, constructive
criticism, honesty and motivation. The leaders should focus on modifying the organisational
policies and employee behaviour as per the nature of the change.
References
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DERUE, D. S., NAHRGANG, J. D., WELLMAN, N., & HUMPHREY, S. E. (2011). TRAIT
AND BEHAVIORAL THEORIES OF LEADERSHIP: AN INTEGRATION AND
META-ANALYTIC TEST OF THEIR RELATIVE VALIDITY. Personnel
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Farzipour, V. (2016). Distributed Leadership and Its Applications in Health Care Settings:
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https://www.softwareadvice.com/resources/reducing-patient-wait-times/
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https://www.strategicmanagementinsight.com/tools/mckinsey-7s-model-
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