Leadership Management and Teamwork in Healthcare

The paper explores and reflects upon the leadership, management and teamwork in healthcare professional practices. It discusses conflicts in healthcare, Driscoll's model of reflection on leadership in healthcare, transformational leadership theory and more.

Running head: LEADERSHIP MANAGEMENT AND TEAMWORK IN HEALTHCARE
REFLECTIVE WRITING ON LEADERSHIP MANAGEMENT AND TEAMWORK
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Introduction
The purpose of the paper is to explore and reflect upon the leadership,
management and teamwork in healthcare professional practices. Leadership in
healthcare can be defined as the behaviour of individual medical personnel while
instructing or directing the tasks to a group of people for a shared goal (Babatunde
and El-Gohary 2018). The main characteristic of a leader is to influence the activities
within a group and ensure effective coping strategies to manage changes (Delmatoff
and Lazarus 2014). Effective leadership is essential for every organisation including
the healthcare institutes and the hospitals (Fitzgerald et al. 2013). Effective
leadership helps to resolve management challenges, staff conflicts and ensures that
the patients get adequate treatment and services in the organisation (Al-Sawai
2013). Effective leadership results in collective teamwork within an organisation,
when information is communicated to the co-workers and other systems associated
with the service (Delmatoff and Lazarus 2014). Based on a significant experience on
medical practice from a prestigious hospital a reflection has been presented. The
Driscoll Model of reflection has been applied to conduct a self-evaluation and event
analysis with precision. Moreover, the framework has also been used to design a
Personal Development Plan (Action plan) to change the course of actions in future
when similar challenges are witnessed.

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Driscoll's Model of Reflection on Leadership in Healthcare
(Source: Babatunde, and El-Gohary 2018)
Driscoll's model of reflection is based on three questions “What”, “So what” and
“Now What” which guides in the process of reflection (Babatunde and El-Gohary
2018).
An efficient leader must be intimidating but at the same time must possess a
set of effective leadership skills. According to Kumar (2013), a leader must have
good communication skills and the habit of listening to his or her team members.

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This improves the team productivity. In addition to this, it is crucial for a leader to be
sagacious, especially within the healthcare industry (Swanwick and McKimm 2017).
The leader must be able to face the present challenges and focus on the bigger
goals of the organisation (Kumar 2013). Also, the leader must be optimistic so as to
lead the team during a phase of crisis (Fitzgerald et al. 2013). It is the responsibility
of the leader to positively influence the staff members who are going through their
worst days (Delmatoff and Lazarus 2014). Also, a leader must be empathic to the co-
workers, which often lacks within a workplace (Giltinane 2013). Lastly, a leader must
have the quality of integrity that is they should remember and tightly adhere to the
ethical code of conduct for the professional practice (Al-Sawai 2013).
In a healthcare institution conflicts can take place between a nurse and a
doctor, staff members and ward managers, doctors or nursing professionals and
instrument technician, patients and their family and other staff members. Effective
leadership and communication can resolve these conflicts (Giltinane 2013). A similar
situation was witnessed in the hospital, where a conflict had occurred related to the
staff room transformation. The staff members wanted to purchase commodities such
as a refrigerator, microwave, radio, and chairs for the staff room. However, the ward
manager wished to invest the money in other things the reason being the money was
obtained from Christmas raffle. In this case, it can be said that the ward manager
was autocratic and imposed his decision on the nurses and doctors. As per Kumar
(2013), autocratic leadership can be defined as the leadership style where the leader
is extremely controlling and does not involve the team members in the decision
making process. The care professionals being subordinates were forced to succumb
to the ward manager’s decision. The ward manger did not exhibit the qualities of a
good leader as he failed to include the team of care professionals in the decision

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making process about the purchase. Upon critically reflecting on the scenario, it was
learnt that conflicts could be avoided within an organization if the leader adapts a
collaborative decision making approach and actively acknowledges the concerns of
the team members (Swanwick and McKimm 2017).
Another episode of conflict was witnessed between a doctor and a staff
nurse. The doctor was planning to discharge a patient with the discharge officer, but
the staff nurse was suggesting that the patient had not recovered completely and
should not be released. However, the doctor imposed his decision on the discharge
officer and asked the nurse not to teach him what to do in an aggressive tone. This
case is another instance of autocratic leadership. It should be stated here that both
the Doctor and the Nurse were equally involved in the process of patient care. While
the nurse emphasised upon the present state of health of the patient, the Doctor
might be considering the wellness pertaining to the recovery of the symptoms (Kash
et al. 2014). However, the Doctor imposed his decision on the nurse in a dominating
manner and this can be explained as an example of autocratic leadership. The event
that followed further can be portrayed as an example of democratic leadership,
where for the discharge planning the nurse leader conducted a meeting with the
multidisciplinary team of care professionals where all the areas of the patient care
process was discussed. This reflects the democratic leadership style where all the
multidisciplinary team members were equally involved in the decision making
process (Kash et al. 2014). From the scenario it was learnt that collaborative practice
and effective inter-professional communication is integral to avoid conflict and
promote positive patient outcome (Giltinane 2013).
Another, example can be cited where a RN had missed out on preparing the
correct dose of medication that was supposed to be administered to a patient. The

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Doctor rebuked the RN openly which lowered her self-esteem. This could be
identified as an example of autocratic leadership where the RN was not even given
an opportunity to explain or rectify an issue. On the other hand, the lead Nurse,
adapted a more humble approach and asked the RN to be cautious and prepare
another medication dose. The RN prepared it correctly this time and the leadership
style here can be identified as benevolent as the leader Nurse took into
consideration the impact that the actions would elicit on the RN’s performance output
(Kumar 2013; Fitzgerald et al. 2013).
As per Lumbers (2018), the responsibility of a leader is to monitor the
everyday activities within an organization. In the first scenario it seemed that there
existed a conflict in the organisation between the care professionals and the ward
manager. The reason was that the staff members wanted to invest the money to
purchase useful commodities which could offer facilities to the staff professionals
against the wishes of the ward manager who wanted to invest the money on other
unimportant infrastructure. The staff (nurses, in particular) also demanded to reduce
the long hours of shifts, and evenly distribute the workload. Therefore, many staff
members wanted the reforms to be brought within the healthcare settings.
On the basis of the evaluation, it was found that the likely outcomes from
these reforms would be positive if the staff services were improved in terms of
accommodation as well as quality. It is vital for the medical unit to provide proper
staff facilities to support the significant efforts of the employees (McCaffrey and
Reinoso 2017). In addition to this, due to the shortage of staff, patient care puts more
pressure and workload on the existing workforce (Netazi et al. 2018). As a result,
they are not able to perform effectively in many critical areas. However, some flaws
were also found in the reform (Mikkelsen, and Olsen 2019). One issue was that the

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ward manager was usually puzzled and involved in chaos probably because of his
inability to distribute tasks to the employees effectively (Kash et al. 2014). Other
reason could be that the manager was unable to adapt to the changes (Gopee and
Galloway 2017). From the evaluation, the ward manager was found blaming the
employees for being incompetent and inefficient of doing their work in a proper
manner and hence refuting to fulfil their demands (McCay et al. 2018).
Within any healthcare organization, conflicting situations between doctors,
managers, patients and nurses are extremely common. Care providers that do not
follow the guidelines and standards of care services leads to compromise of care
services that affect the workplace (Gopee and Galloway 2017). It has been analysed
that leadership is the capability of an individual or a group of individuals to influence
and direct followers and other members in the correct direction (NHS 2018).
Efficient leaders and managers are essential at every level around social care
to ensure high quality output (Richter et al. 2015). The leader must possess several
qualities while effectively performing the tasks and duties (Giltiinane 2013). The
qualities of a leader include honesty, effective communication skills, accountability
and integrity, t decision making capabilities, creativity, innovation, awareness, and
passion (WHO 2018). The analysis says that strong communication plays a unique
role in leadership and management within health care settings (Boamah 2018). The
patient's awareness for the quality of health care services they received is highly
reliant on the quality of their communication and interactions with the health care
professionals (NHS ENGLAND 2018). Open communication style helps people
understand and evaluate each other, and as a result, it brings them closer to each
other (Davies and Malek 2017).

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One of the critical issues that was observed in the hospital was the effect of
change management. The health care experts and professionals were staying away
from their responsibility to undertake their professional tasks. This way of working
made them unable to perform functions and duties in an efficient manner (NMC
2018). Handling change is about planning, analysing, initiating activities, strategies
and functions and making sure that the change is valuable and useful (Royal College
of Nursing 2018). Enhancing change is both fatiguing and demanding (NHS England
2018). Bringing dynamic changes needs the manager to challenge the standard and
requires persuasion against the norms, values and habits of the set behaviour and
actions (ROYAL COLLEGE OF NURSING 2018). Management changes require
sufficient time and commitment of people (Monkhouse et al. 2018). It is evident that
management changes in health care settings are welcome if they enhance and
improve safety and quality and save extra expenditure (Richter et al. 2015). For
example, changes in technology, care delivery and patient's demands are increasing
the role and value of nurses in health care settings (Gopee and Galloway 2017). To
manage change management, health care and hospitals should conduct training and
development sessions and programs effectively (Günzel-Jensen et al. 2018).
Moreover, the hospitals need to focus on the issues, queries and problems of the
employees who are resisting the integration of change (NHS England 2018). It would
help the leaders to understand and implement the change management in health
care settings properly (NHS England 2018).
Transformational Leadership Theory
Transformational leadership style seems to fit perfectly in the given scenario
to prepare staff for the organisational change, and handling conflicts and
disagreements effectively (Swanwick and McKimm 2017). It can support and foster

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the professional practice environment that ultimately leads to excellent patient care
(McCaffrey and Reinoso 2017). The transformational leadership could be deemed
appropriate to prevent the discussed conflicts (Davies and Malek 2017).
According to this leadership style, first, the team leader in the present
scenario should schedule an appropriate time and select a private room for a one-
on-one discussion with the staff to reassure respect and trust (Boamah et al. 2018).
At this phase, it is important to reveal that this is just a discussion, similar to the
process of storytelling rather than a method of disparagement (Al-Sawai 2013).
Secondly, while talking to the staff, the ward manager needs to listen carefully to the
staff's thoughts, as it is essential to know the needs and concerns (Boamah et al.
2018). Thirdly, the ward manager should consider the severity of the issue.
Simultaneously, the unit officer must present his expectations for the staff and the
unit, which could inspire them towards further career development and promotion
(Babatunde and El-Gohary 2018). Through transformational leadership, staff
behaviour can be influenced positively (Boamah et al. 2018). Additionally, it has also
been reported to improve their organisational commitment so as to help achieve the
organisation's goals as a team (Spaulding et al. 2017).
For the first scenario, the Ward manager must make arrangement for the staff
members to take rest breaks, have hot drinks and be able to eat. The organization
had a system of half an hour + half an hour break for the care professionals working
in the night shift. This system caused inconvenience to the professionals and their
demand was to unite the two breaks to a one hour break so the professionals could
rest appropriately. The ward manager is also required to arrange proper restrooms
and rest areas for the nurses especially, where the work involves exposure to noise,
dust, chemical agents, fumes and high or low temperatures. As stated by Fitzgerald

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et al. (2013), employees perform best when the work environment is comfortable.
The principle should ensure that the staffing professionals do not need to spend all
their time at work in an increasingly dangerous environment (NHS England 2018;
Kash et al. 2014)). The ward manager should also make sure to provide facilities that
enable pregnant and nursing mothers the opportunity to lie down and rest (NHS
England 2018).In the next scenario, the Discharge officer should make sure that the
doctor does not suppress the nurse. The Discharge officer should make sure that the
nurse does not feel low and motivate her to continue her work.
Based on the analysis, it was observed that top-level management needs to
show their cooperation in handling such conflict laden events (Kumar 2013). For this
purpose, the ward manager and supervisors who were against the proposed
changes must be given effective orientation and training (Boamah et al. 2018).
Regular seminars should be conducted to make the employees understand the
positive impacts of an organisational change, and negative impacts of unnecessary
chaos (NHS ENGLAND 2018). One of the essential actions to accomplish this is to
lead the workforce of the medical unit by a transformational style of leadership.
These actions would be useful in influencing, motivating, and inspiring the staff and
ward manager towards the right path and the vision that the medical unit wants to
attain (Davies and Malek 2017).
As the ward manager seemed resistant to the new initiatives in the medical
unit and the doctor hesitated to take advice from a nurse, they should be given
proper training and information about change management and collective
responsibility (NHS 2018). The need of communication is to make the employees
aware about the benefits of changing the services of medical units from twenty-four-
hour in-patient services to operating day care services, for making the staff more

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productive, energetic, and competitive (WHO 2018). This strategy would make the
individuals realise about the necessity and importance of implementing the initiative
to enhance the quality of care they commit to deliver to the patients (NMC 2018).
Besides, the managers and leaders should play a key role in the health care
system to meet the service quality and expectations. The managers need to be
accountable to handle administrative tasks, like human resource, budgeting, finance
and management (NHS ENGLAND 2018). The managers need to be liable for
handling staff, admissions, discharge, budget and quality of care (NHS ENGLAND
2018). On the other hand, the clinical managers should also take responsibility for
overseeing a particular aspect like surgery, nursery, and physical therapy and have
specific duties based on their perfection (Gunzel-Jensen et al. 2018). Apart from this,
health information managers should be answerable for the maintenance and safety
of the patients' records (Giltinane 2013).
It is evaluated that a culture of the health care settings shall be favourable and
useful to increase patient safety and security (Gopee and Galloway 2017). The
culture can be promoted by procuring the support of team members and participating
in their professional enhancement (McCay et al. 2018). The key is aligning
employees to culture. The leaders need to maintain good communication and
relationship with staff to gain the support of team members in healthcare settings
(Davies and Malek 2017). It will help in making a strong and dynamic culture within
the organisation (Stegen et al. 2018).
Moreover, one of the significant parts of developing a health care culture is
related to generating a workplace that is respectful and effective (NMC 2018). The
top management in health care settings should provide motivation and rewards to

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the potential employees who are serving patients properly (NMC 2018). It will help in
enlisting the support of workers and contribute to their professional development
(Monkhouse et al. 2018). With a redesigned sense of insight and awareness, the
great leaders or managers would understand the weaknesses and strengths of their
team members and know how to bring out the best from the employees (Netrazi
2018). If the leaders provide a challenging task to a staff, then it will help in
developing and improving the professionals. The managers further can support team
members by reviewing and analysing work frequently and effectively (NHS England
2018). Besides this, leaders must also develop interpersonal and professional skills
of the team members by conducting various training sessions (Davies and Malek
2017). It helps in maintaining a healthy and favourable work environment. Along with
that, the leaders must establish trust among the team members and promote
discipline at the workplace (WHO 2018). These aspects would help in promoting a
positive work environment.
Conclusion
It is concluded from the above reflection that leadership and management
play a key role in healthcare settings to serve many stakeholders effectively. It was
learnt that managers need to possess various skills and qualities to attain the needs,
and expectations of the employees so that they can deliver the best services to the
patients (Fitzgerald et al. 2013). Efficient managers lead to high profitability and high
stakeholder satisfaction (Netrazi et al. 2018). Along with this, transformational
leadership helps the leaders in maintaining a strong culture and positive environment
in the workplace by managing workplace conflicts (Shah 2017). It was also learnt
that the skills and qualities that are needed to meet the service quality and
expectations also include interpersonal skills, relationship skills, and analytical skills

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(Monkhouse et al. 2018). Using these skills, professionals can meet the needs and
requirements of the employees as well as patients by making them happy and retain
for a longer time (Royal College of Nursing 2018).
ACTION PLAN:
In order to execute the proposed changes, the transformational style of
leadership would be put into practice. The needs and expectations of the staff
members would be fulfilled through regular communication (NMC 2018). All the
facilities that they require would be considered and implemented to make them more
productive (NMC 2018). Every employee would be given preference, and the seniors
would value their juniors’ opinions and not shut them up (Royal College of Nursing
2018). It will evoke a strong sense of belonging within the organisation. This strategy
would increase its level of output and would contribute to the success of the
organisation in the long run. Also, training sessions would be conducted in order to
impart knowledge about the NHS leadership model so as to motivate the workforce
and acquire excellent service delivery (NHS Leadership Academy 2019).

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Appendix
Personal Development Plan:
On conducting a self-assessment I have identified two key areas that require
continuous development, firstly, I would need to work on my communication skills
which I would master by attending workshops on effective communication. Secondly,
I would need to develop an in depth knowledge about different leadership style which
I would do by browsing through informative materials on the internet. Further, I would
also browse materials and develop an in-depth understanding about the NHS
leadership model in order to improve on my leadership qualities which would help
me in my future scope of practice.