Innovation in Asthma Therapy: Leadership and Change Management Perspective

This paper discusses the case of Asthma Exacerbation and proposes innovations to develop an optimal care program for the patients. It covers the innovation in accordance with best management practices and change in the nursing management practice with the best change management tactics.

Contents
Introduction......................................................................................................................................2
Discussion........................................................................................................................................2
2a Leadership...............................................................................................................................2
Transformational style of leadership for bringing innovation in Asthma therapy...................2
The technical part of the Asthma Management........................................................................3
Swot Analysis of existing system.............................................................................................5
2b Innovation...............................................................................................................................6
Transformational leadership clubbed together with an apt change management model can
make a difference.....................................................................................................................6
An example of contingency leadership can make a difference................................................8
2cChange management................................................................................................................9
Change and change management theories that can be applied.................................................9
Change management model of Kurt Lewin along with the transformative style of leadership
..................................................................................................................................................9
Use of evidence to support the change management proposed by us....................................10
The role of Evaluation in the process of change management...............................................11
Conclusion.....................................................................................................................................11
Bibliography..................................................................................................................................12
Appendix 1: Smart Action Plan.....................................................................................................14
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Introduction
Medical Science is suffering from an acute shortage of trained nurses and other medical experts.
The pervasiveness of this problem changes its face in different setups. For instance, nursing
professionals working in the urban areas of the world are adopting management models to
provide volume-based services. It means that managers looking after the operations at clinics and
other outlets want every employee to attend the maximum possible number of patients in a given
day. If urban areas are suffering because of the high population density then rural areas are not
far behind (Shea, 2018). Here the density of the population is less but the medical facilities are
not available easily because they are located in the far off cities. Most of the rural and remote
areas of the world are seeking for some management models where they can offer value-based
services (Hodgin, 2018).
In the current assignment, we are discussing the case of Asthma Exacerbation. We will try to
come up with some innovations to develop and optimal care program for the patients. For this,
we will take the support of well-defined leadership models and action plans based upon the
SWOT analysis and other conditions associated with Asthma exacerbation. The scope of this
study covers the innovation in accordance with best management practices and change in the
nursing management practice with the best change management tactics.
Discussion
2a Leadership
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Transformational style of leadership for bringing innovation in Asthma therapy
Transformational style of leadership allows a leader to enable nursing staff to meet with new
challenges by changing some of the methods that are involved in the practice. Any given task
related to nursing practices can be divided into two fragments. The first fragment belongs to the
technical aspects and the second aspects belong to the managerial aspects (Sfantou, 2017). In the
current paper, we are going to discuss some of the managerial and training based practices that
have the power to transform the capacity of nursing staffs working in primary health care centers
of Canada. This program will also help the nurses in acting as the agent of the change.
As a profession, nursing demands the highest order of professionalism. It happens because the
margin for the errors is zero. With the help of the transactional style of leadership a leader can
force his students to learn some lessons in a hard way (Xu, 2017). This is why a leader is
required to follow a modified version of the transformative style of leadership.
The technical part of the Asthma Management
Let's have a look at the details of a patient suffering from acute asthma. Acute Asthma
exacerbations are the most common respiratory diseases requiring emergent medical evaluation
and treatment. It is characterized by inflammation of the airways, associated with hyper-
responsiveness of the airway smooth muscle (Burn.D, 2013).
Nurses are at the front line of asthma management, and have the crucial role of early
identification and management of uncontrolled asthma empowers nursing staff to administer a
relief medicine in a puffer to open the airways and ease breathing which has reduced wait time
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and improved patient care. Together with training nurses in lung auscultation enhance nursing
autonomy. The nurse manager of the clinic assumes a leadership role in the clinical setting. It is
useful for a nurse manager to be identifying the leadership styles and theories relevant to the
nursing practice (Dolins, 2017).
In the current assignment, we are looking at the operations from a different viewpoint. This is a
point view where we are stepping into the next level of management as it is prescribed by the
evidence-based practices. This is the viewpoint of a manager and we are treating nursing staff
and their tasks as the logistics in the factory of the cures.
When we specifically deal with the case of Asthma exacerbations then we find that it is a
potentially life-threatening condition, where a subject leads towards breathlessness, this
condition can become precarious if the help gets delayed (Ho, 2009). It also means that an
average patient suffering from this type of Asthma needs two types interventions, first we need
to check these patients on a regular interval to keep a check on the damage, second, sometimes
we need to treat them with the help of first response when the things are becoming critical.
In the case of places like Singapore, we find that most of the patients often search for Primary
Care Clinics because they are affordable options for them. The health care system of Singapore
is very strong and this free service definitely attracts a large number of people into these clinics.
When we check the evidence-based practices associated with the management of Asthma and try
to fix them under a managerial framework then a different picture appears in front of us. While
adopting any particular style of leadership we should not forget the nature of the job. After
understanding the nature of the job the next thing comes into the practice is the SWOT analysis
of the existing system.
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Swot Analysis of an existing system
Strengths Presence of the
evidence-based
practices to handle
common and
emergency situations
Presence of
knowledge where
tools like
symptomatic
diagnostics can be
practiced.
Weaknesses Lack of trained staff
that is aware of the
Evidence-based
practices
Lack of trained nurses
to identify various
stages of Asthma on
the merits of
symptomatic signs.
Overcrowding of the
place and this crowd
can force nursing staff
to bring down the
quality of the
treatment because
they will not be able
to give enough time to
every patient.
Opportunity The information level
of the general patients
and nursing staff is
increasing because of
the easy availability
of knowledge on the
We can employ more
staff and trained
nurses can increase
the density of the
service providers.
Some of them can
An overcrowded place
presents an
opportunity for
nursing staff, where
they can increase their
wisdom by gaining
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internet and other
sources.
even be promoted as
independent
practitioners.
practical experience.
Threat On certain occasions,
they can misfire in
judging an SOS
situation.
Lack of well-trained
staff can leave many
serious patients
unattended at the level
of the diagnostics.
Mental fatigue and
physical fatigue can
increase the chances
of forced errors while
offering services.
The inception of the right management model in any given hospital can be considered as an
innovation by all the possible standards. We are aware that medical science defines its practices
with great precision and changing them is very difficult because they are unrooted. Many
commoners feel that the introduction of a new medicine, therapy or a device is innovation.
However, in the field of nursing, it is not true. Devices and tools can replace certain techniques;
they cannot change the basics of medical science (Onubogu, 2019).
2b Innovation
Transformational leadership clubbed together with an apt change management model can
make a difference
Let's take the case of Asthma patients visiting primary health care centers in Canada from a
different point of view. For this point of view, we need to first understand the "principle of the
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distributive justice." Let's imagine about a queue of the patients, in general, this queue follows
the rule that says "first come first serve." The principle of distributive justice looks at it
differently; it says that a person with the immediate need of therapy deserves it first. If we have
two subjects with equal need then we need to choose the subject with better options for survival
(Bowler, 2018).
In order to introduce an innovation in the existing queue system with the help of leadership and
organizational changes, we can first convert this queue into a pipeline with conduits at various
levels. In the practical case of Asthma patients visiting a primary health care center in Canada,
we consider the queue of the patients as a pipeline and various ports where they go for
symptomatic diagnostic as the conduits (Morris, 2019).
The transformational theory was originally identified by James MacGregor Burns. According to
Burns transformational theory focus on the connections formed between leaders and follower
( Rose Ngozi Amanchukwu et al 2015). Transformational leaders motivate and inspire people to
work toward a common goal. Witges (2014) mentioned that Transformational leaders inspire
follower beyond their own self-interests to a vision that aligns with the organizations’ values and
mission. Doody (2012) only stated that transformational leadership recognizes the importance of
rewards, but goes further to satisfy the emotional and intellectual needs of staff (Richardson,
2016).
Introduction of transformative leadership in case of Asthma management in Canada can give us
interesting results in terms of increased efficiency of the patients. They capitalized on the
strengths of the framework related to the "principle of the distributive justice" and the addition of
the experts at lower level dealing with a selective set of problems helped them in creating a
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pipeline structure. The queue moves, but a pipeline flows, the transformative leaders in the form
of Asthma experts helped the government in handling a difficult situation (Bahrmann, 2010). A
transformative leader is someone who enables his subordinate in acting like him. We should not
mix it with Transactional leaders; transactional leaders outsource their work to their
subordinates. Transformative leaders, on the other hand, enable their subordinates to work under
the same capacity as their leader was working. Many experts believe that the transformative style
of leadership is an innovation in itself because here
An example of contingency leadership can make a difference
Here we would like to present the example of New Delhi. During the year 2018, heavy smog
surrounded densely populated Delhi. A big population of the city all of a sudden realized that
they are not able to breathe properly (Kaul, 2016). For a better understanding of the event, we
can compare it with an epidemic. The load on the primary health care units increased drastically.
In order to cut down this load, major hospitals of Delhi took an initiative; they conducted various
workshops and tried to develop resources in their existing workforce. First, they introduced a
separate breathing trouble department in each unit and created direct conduits on each port. Here
they enabled the nursing staff in two ways. First they were capacitated to handle simpler cases,
second, they were allowed to refer complicated cases as per the merits. It means instead of the
queue they made a pipeline. In order to release the pressure from the pipeline of the patients,
they introduced the right kind of conduits as well (Sharma, 2016).
This type of leadership style is known as a contingency leadership style. Imagine a nursing staff
practicing his or her discretion in picking up the right referral for a patient. This arrangement
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worked well because simple cases met with the general physicians and suspected cases of the
Asthma were sent to the Asthma experts.
2cChange management
Change and change management theories that can be applied
After the arrival of internet technology, the things are changing fast, this is why in recent years;
change management has emerged as a separate branch in the field of management. The need for
the change management agents occurs at its first place because in most of the cases the
organizations fail in looking at the change in the process from an objective point of view. This is
why we need to commission a separate department to look after the task of change management.
We have studied two cases in this compilation, so far (Munde, 2017). The first case is of Primary
health care units in Canada; here we used a transactional style of leadership.
Change management model of Kurt Lewin along with the transformative style of
leadership
The selection of the Leadership style in the case of Singapore primary health care units and
management of Asthma gives us a scenario where the change management model Kurt Lewin
can deliver the best results. This model follows three steps, Unfreezing, change and freezing
(Hussain, 2018 ). Introduction of the asymptomatic questionnaire can be considered as the
unfreezing of the employees. Many employees doubt themselves; they feel that they are not able
to deliver the goods. During the phase of unfreezing, a leader should adopt the policy of offering
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generous rewards. During the step of the change, they should keep a check and balance on the
performance of the individuals. In the third step, a leader can award status to the employee and
freeze him under his new role (Akram, 2016).
The nurse is playing the role of the agent of the change in this process, here the nursing staffs are
first converting a queue into a pipeline and then in the second step they are also acting as a
conduit to release the pressure from the higher ends. They are acting as the agent of change by
participating more actively in the responsibility matrix derived for the process (Adler, 2010)
Use of evidence to support the change management proposed by us
The second case of New Delhi India allows us to explore the Bridge’s transitional model. In this
transitional model, we have three steps. In the first step an employee or a nurse may feel that he
or she is overworked, it happened in the case of New Delhi changeover; many individuals
working in the nursing staff were reluctant to the change (Dutt, 2017). As a result, some of them
became neutral to the change and confined their learning curve to the changes that authorities
were making. While going for a contingency based change a leader should never forget that an
organization is doing a change for good. They are not changing an individual because he was
wrong. They are changing a working pattern because they want to bring the best out of him. The
government of New Delhi adopted an arrangement that can be compared to the Bridge’s
transitional model. In the first step, they trained employees. When the attack of Asthma erupted
because of the SMOG attack, these employees neutralized their other skills and worked under a
limited capacity. However, once the impact of the epidemic died down, the government of Delhi
started the concept of “Mohalla Clinic” and thus they completed the third step of Bridge's third
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model where they converted an emergency arrangement into an on-going process (Gorman,
2016).
The role of Evaluation in the process of change management
Are we heading towards the right direction or not is a big question while dealing with the
exercise of the change management. Transformational style of leadership gives us ample
opportunities in terms of checking the growth of an employee or nursing staff. The selection of
the change model developed by Kurt Lewin justifies our choice (Crawford, 2016). The change
model of Lewin suggests that prior to unfreezing the organization or the process; the company or
the nursing care unit should fix some goals and scenarios, in the case of our solution we
introduced conduits in the pipeline of the patients, these conduits will refer the patients directly
to the right experts and control the traffic of the patients. The freezing point of this arrangement
will be the point when the system developed by us will be able to deliver “each patient in
accordance with his ability to bear the condition and each patient in accordance to the necessity
of the cure at an earliest (Xing, 2009).” Kurt Lewin model allows us to check the status of the
operations prior to freeze them and this is where we can evaluate them and check them with the
objectives set by us.
Conclusion
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Many experts in the field of management advocate that " leading by the example" is the best
leadership style when a leader is dealing with a team where the margins of the error are low or
zero. Here we would like to supply a fact that most of the practices in the field of medical
science follow this principle of "leading by example." Every evidence-based practice is an
"example" in itself. Every inventor of evidence-based practice is a leader.
On the scale of change management, transformative style of leadership is very effective because
it is creating trained employees with each transaction and thus the knowledge gained by a nurse
is making them a thorough professional in the field of Asthma. Transformative style of
leadership has the potential to bring in a sea change in the procedure by converting a queue into a
pipeline and make it more fluid in the terms of volumes. This model also separates the patients
that are seeking value-based care. After separating these patients they can be referred to other
areas.
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Appendix 1: Smart Action Plan
The smart action plan to deal with Asthma Management in Singapore can work upon two layers
of leadership models and two change management models. We can introduce nursing managers
as contingency leaders in the primary clinics and enable nursing staff to complete a few expert
processes. Asthma is a season bound disease, during the month of winters the number of the
patients can shoot up drastically (Holmes, 2017). The winter months are also the months when
most of the nursing staff wants a holiday and it affects the supply of the trained hands.
Contingency style of leadership can help us in handling this excessive traffic during odd hours.
The example set by the health units of the New Delhi confirms our thought process by presenting
any evidence for it.
In recent years, many countries across the world have come up with the concept of specialized
primary health clinics. For instance, we have separate diabetes management clinics, clinics for
elderly people and clinics to manage cardiac ailments. In the same fashion, we can come with
specialized Asthma clinics or at least open a separate department for Asthma patients (Chung,
2018).
The inclusion of this department can be done with the help of the transformative model of
leadership. This model will help us in handling the volume of the patients. It will also enable us
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in identify and filter the cases where value-based intervention is needed to handle certain
complex physiological and psychological conditions (Procter, 2015).
Introduction of transformative leadership style always presents an opportunity in front of us
where we can change the nature and the information level of an existing workforce and utilize
them in a different manner to serve a different type of objectives. A mix contingency leadership
style along with the transformative leadership style has the potential to give us a working model
where emergency needs can be catered easily and we can launch some self-sustainable projects
when we need to branch out.
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2b: Innovation in Healthcare
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