Role of Transformational Leadership in Healthcare: Bedside Handover

This essay critically analyzes the role of transformational leadership in enhancing bedside handover processes within healthcare organizations. The introduction emphasizes the importance of leadership in improving patient care and safety, highlighting the significance of effective communication and coordination among healthcare staff. The main body delves into the concept of transformational leadership, emphasizing its ability to motivate and guide healthcare professionals, improve performance, and foster a positive work environment. The essay identifies the challenges associated with bedside handover, such as communication gaps and the need for accurate information transfer. It then introduces Kotter's eight-step change model as a framework for implementing performance improvement strategies, outlining each step and explaining how a transformational leader can facilitate the change process. The essay emphasizes the need for change, the importance of building a guiding team, and the significance of communication and short-term wins in ensuring the success of the change initiative. The conclusion reinforces the critical role of transformational leadership in driving positive change and delivering quality healthcare services.

Running Head: Transformation Leadership in Healthcare
Role of a leader in healthcare Industry
Essay
MAY 25, 2019

Transformation Leadership in Healthcare 1
Introduction
Healthcare qualities in clinical practice is essential for the better patient care and for their
proper diagnosis and treatment of patient. In such scenario, the role of a leader is so important as
a leader motivates, guide, and direct nurses and other healthcare staffs about the care procedures
and quality. A leader in the healthcare organization is significant because it not only guide and
motivates people rather a leader ensures the patient safety and care while monitoring and
evaluating all the necessary healthcare practices of staff and nurses. To improve the healthcare
quality in organization, clinical handover process among the nurses during the treatment of
employees is crucial and it should be managed in appropriate manner. Here, proper coordination
and communication among the nurses are necessary. To improve these things in the healthcare
organization only possible when a leader performs his job and guiding and directing people for
their individual roles in the organisation. However, managing change in the healthcare
organization is also essential to adopt the constant technological and environmental changes in
the healthcare industries and care quality. This article shows the role of a transformational leader
in healthcare organisation and clinical practices. The present essay topic considers the role of a
transformational leadership in bedside handover in a healthcare organization and focuses on the
role of a transformational leader who can bring the required changes to improve the care
qualities in the healthcare organisations.
Thesis statement
Role of a transformational leadership in improving the bedside handover in the healthcare
organization and Kotter’s Change model.
Aim
The main objective of this essay is to provide an understanding about the role of a
transformational leadership and how a leader can use the Kotter’s change model in improving the
performance of nurses and staff during the bedside change work in healthcare organisations.
Main Body (PART-A)
Transformational leadership and performance improvement
Role of a leader in improving the healthcare services in the organization is so crucial. It
can be said in other words that leadership is the key and primary need of any healthcare

Transformation Leadership in Healthcare 2
organization for improvement. The relationship between leadership and improving the quality of
care is the fundamental interest for the people and professional’s group. Both the concepts are
highly debatable agenda in the healthcare industry. A leader a person who not only focuses on
motivating and encouraging employees rather his/her suggestions and help the other member and
staffs of the organization to improve their performance in the organization (Anders & Cassidy,
2014).
The transformational leadership is a leader who not only lead the people from the front
rather also motivates them towards the organizational success. In a healthcare organisation,
moral, performance, and motivation of employees is necessary while performing the healthcare
activities (Varkey & Antonio, 2010). Therefore, a transformational leader feed these all qualities
in the healthcare staff and employees to perform the job effectively and efficiently. It has been
seen that most of the healthcare workers are facing problems during bedside handover process
and a mistake can cost the lives of patients. However, a transformational leader can improve the
work of these people by enhancing their communication quality and establishing a good
coordination among the healthcare employees in the healthcare organization. A transformational
leader always keeps their ego under control and when he is in a position of power (Brandis,
Fitzgerald, Avery, McPhail, Fisher, & Booth, 2016). A leader always focuses on take the right
risk and bring relevant changes in the organisation and responsible for what happening in the
organisation. However, making change in healthcare organisation to improve the various
healthcare functions is not a single stroke action rather it is a systematic process in which a
leader will ensure that every people contribute in the organizational goal and perform at their
best level. People need inspiration and motivation to improve their performance in the healthcare
organisation and a transformational leader may prove himself as one of the inspiring factor in the
healthcare organisation (Clarke & Persaud, 2011).
Performance improvement in the healthcare organisation and Role of a Transformational leader
Improvement in the work performance leads to better patient care and patient satisfaction.
Improvement not only helps to improving the performance of staff and employees in the
oragnisation rather it also leads to smart clinical practices and better outcomes of the healthcare
practices. Performance management also leads to less waste and more efficient use of resources.
However, improvement in the organization especially in bedside handover work is necessary

Transformation Leadership in Healthcare 3
because it is directly related to patient care and safety. The bedside handover in the clinics can be
in form of linguistic, orally, or in written communication form (Andreatta & Marzano, 2012).
However, it has been seen that most of the nurses and staff doing wrong while changing their
shifts and jobs or replacing other staff by self and give them all the information related to patient
care, treatment, and upcoming treatment process and care. Lack in structural communication and
giving false information during bedside handover is the major problems and it can be solved with
the help of a transformation leader. Although the leader needs to bring change in the organisation
to improve this situation and improve the organizational performance in healthcare center. The
change not only improve the performance of employees rather it also helps to ensure patient
safety (Evans, Murray, Patrick, Fitzgerald, Smith, Andrianopoulos & Cameron, 2010).
The strength of transformational leader helps to other people to identify the strength
weakness of other clinical staff in the organization. It has been found that most of the nurse faces
strong job stress during their work period, which is the major cause behind bedside handover
problem in the organisations (McMurray, Chaboyer, Wallis & Fetherston, 2010). A
transformational leader can help these types of nurses and staff to come out from the stress and
motivating them for the best performance. A leader has responsibility to ensure that
organizational climate for these staffs should be suitable and people can enjoy their work during
the patient care or other healthcare work in the organisation. Although, it can be said that the role
of a transformation leader not limited to improving the performance of the employees rather it
also helps the organisation to ensure that proper communication can coordination establishes
among the all nurses and staffs (Hayden, 2017).
As per the above analysis about the role of a transformational leader and his strength to
manages adverse situations and encourage people for performance improvement, it can be said
that the transformation leadership is critical factor in the success of the organization and that
helps to deliver quality healthcare services in the organisations. However, the problems and
challenges related to bedside handover needs implementing a change process in the organisation
which will be helpful in improving the performance of employees and overcome the issues and
challenges that healthcare staff and nurses faces during the clinical handover.

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PART-B
Need for change organisation during bedside handover in clinics
The major problem in the healthcare organisation that various staff and nurses faces
problems during the clinical handover process. The improper communication, poor coordination,
irrelevant information or message, improper understanding of work, poor support from the
administration department some of the causes that can create challenges during the clinical
handover process. The main purpose of clinical handover in the healthcare organisation is safe
transfer of patient with patient’s responsibility to one staff to another staff and through proper
communication and excellent class clinical information. A bedside clinical handover means
transfer of accountability and responsibility for some or all aspects of patient care for a patient or
group of patients on a temporary or permanent basis to ne nurses to another nurse or one
department to another department. Lack in structural communication and giving false
information during bedside handover is the major problems in the healthcare organisation and
these challenges need to improve by implementing change in the organisation. However,
improper use of technology is also a major cause in clinical handover because it reduces the risk
of sharing inappropriate or irrelevant data or information about the patient (Delaney, 2018).
John Kotter’s Eight Step Change model process and role of a transformational leader
John Kotter’s thinks that organizational change is the crucial thing for performance
improvement in nay organisation and he advocates an eight-step change management model that
helps to manage and implement the changes in the organisation (Donnelly & Kirk, 2015). The
Kotter’s model divided the change model into three phases. The eight steps included in his model
are as follow:

Transformation Leadership in Healthcare 5
Three phases and Eight Steps of Kotter’s Model
Phase-I
(Creating a Climate for Change)
Phase-II
(Engaging and enabling the whole
organisation)
Phase-III
(Implementing and
sustaining change)
1. Increase urgency
2. Build guiding teams
3. Get the vision right
4. Communicate for buy-in
5. Enable action
6. Create short-term wins
7. Don’t let up
8. Make it stick
To understand the Kotter’s change model the employees and change agent in the
organization must understand the importance of all these three phases and how these changes can
be implemented in the organization. A transformation leader can here play the role of change
agent and inspire the whole management and organisation team to implement the changes in the
organization. However, during any phase of bringing change by the transformational leader may
face several adverse situations in the organisation when nurses or staff or employees resist the
changes. The employees will anger, frustrate, panic, cynicism, or feeling issues related to false
pride, anxiety or any other issues related to feeling of complacency. These all emotions are the
important factor in bring change in the healthcare organisation (Matic, Davidson, & Salamonson,
2011). Kotter’s point of view regarding bring change in the organization is somewhere
influenced by the need of improvement in the organizational performance and prepare
organizational people to accept changes with greater acceptance. Kotter’s finds why change is
necessary in the healthcare organisation, Clinical bedside handover in healthcare organisation is
a communication and coordination event among the nurses during change of duty or change in
responsivity during shift change.
PHASE-I
The first phase includes three steps that is helpful in creating a climate to bring change in
the organization. Accurate communication during the clinical handover is the key issues and it
must be understanding by the transitional people. Until people will not understand the
importance of proper communication, the role of change management will not be succeeded to
bring positive change in the organisation (Noble, Lemer & Stanton, 2011). Thus, the first step of

Transformation Leadership in Healthcare 6
Kotter’s model is to understand the urgency of change that why change is required in the
organization. A leader can persuade the nurses and people of the organisation that they can use
the technology and information system for transferring accurate and clear information on the
patience treatment and care to the next department or person who will receive the responsibility
and accountability next of the patient care and treatment. Thus, increasing urgency for change is
required and it is the first step of Kotter’s change model (Francis-Shama, 2016).
The second step in the Kotter’s model is to build guiding team. A transformation leader
in the organisation not only helps to implement these changes rather guide people with greater
influencing power and communication skills. Building teams for guiding people in the
organisation need a group of competent people who can easily motivate and provide knowledge
about the change and ask them to believe in the system (Siemsen, Madsen, Pedersen,
Michaelsen, Pedersen, Andersen, & Østergaard, 2012). For example, convincing people for
using phones and laptop is dangerous during the patient care job and they should focus on the
proper treatment and care of the patient rather than preparing phone. It may cause that nurses can
miss to record some important information and while they are doing clinical handover to other
nurse, they will miss to provide important information about the patients. This will really
dangerous for the patient safety and healthcare purposes. However, the role of transformational
leader is here to motivate and encourage people for patient safety and the guiding team ask the
people to do not use phones while monitoring the patient and provide treatment in the ward
(Cornett, Thomas, Davis, Mahanna, Cordova, Herring, & Randolph, 2012).
The third step in the Kotter’s change model is to set a clear goal for the staff and
employees that what they want to achieve from implementing change in the organisation. A
leader can set the vision and target for the entire staff and ask them to work for the organizational
target. Considering the clinical handover process, the major target and objective of the change
should be proper patient care and improve the communication process and coordination among
the employees thus this target can be achieved in real manner with great employee’s efficiency
(Lewis, 2012).
PHASE-II
To effectively use the change model, it is necessary to assess the impact of change that
who will be affected by the change and how they will be affected. For example, restricting the

Transformation Leadership in Healthcare 7
use of phone affects the nurses, physicians, staffs, other employees, pharmacists, patients, ward
boy, or any other people. The group of guiding teams which was established in step two, are
responsible for creating projections for every individual, group, or organizational member that
how the proposed change affects their communication process, actions, information needs, and
roles in the organization (Ray & Breland, 2011). The development of the projection can help the
organization and leaders to bring the change and provide appropriate and relevant message to
each member who involved in clinical handover work. Here the role of a transformational leader
to encourage and motivate people to accept the changes for the long-time benefits and improve
their organizational performance (Johnson & Cowin, 2013).
(Source: Lewis, 2012)
The fifth step in Kotter’s model is to empowering actions and enable the change process.
After more and more people engage in the change process and involved in the project, the
chances of creating obstacles in the change process will also be increased. For example, the
barriers can be in form of lack of information, involvement of supervisor because of fear
arrogance, and other mental barriers that create obstacles in the mind of people. This fear can be
in form of resistance of both top level and lower level employees. Thus, here the role of

Transformation Leadership in Healthcare 8
transformational leader will be required to motivate and encourages people (Storm, Laugaland,
Dyrstad, & Aase, 2014).
Resistance of change and organisation culture
It is the human nature that people always resist change. No one want to accept new
changes to change their daily pattern of behavior. If the organization will bring change to
improve the performance of nurses or staff during the clinic handover process, it is sure that
nurses and other staff resist these changes. Here a role of transformational leader is so crucial as
he can motivate people and encourage them to accept the change. Here, the culture of
organisation also does matter that people ae living in what conditions and why they do not want
to accept changes. An innovative and supportive culture in the organisation always support the
top management and their organizational leader to implement the changes but lacking in proper
culture may leads to resistance of employees towards the change process. Here, the role of
transformational leadership is crucial as he can mentor and guide people about the changes and
tell them how they can be benefited from the proposed change.
The sixth step of the Kotter’s model is to create short terms goals and assess the change
process and method on regular basis. As change management will be exercising successfully, the
transformational leaders should be empowered the individuals and group member to complete
the jobs according the new change process. The short-term goals and wins clear the path of
implementing change in the organisation. For example, if restricting nurses to use mobile phones
during service reduces the inefficiency of these people, and improve the patient care health,
information and data related to patient treatment can be share to other nurses, the short-term
goals will be achieved and create the path for long term objectives and success (White, Wells, &
Butterworth, 2013).
PHASE-III
The seventh step of the Kotter’s model is related to periodic review and monitoring of
change process. It has been seen that the change management team after implementation and
successful running of the change, left the thing and realize that the problem is solved now and
their work is over. However, monitoring the communication process among nurses, evaluation

Transformation Leadership in Healthcare 9
their approach towards the job, and how they adopt the changes etc. all necessary for the change
management team to review on regular basis. This determine the success of the change during
the implementation of change management process in the healthcare organization (Kazmi &
Naarananoja, 2013).
The last and eighth phase of the Kotter’s model to ‘make change stick’. Here, a leader
should focus on changing the culture of the organisation if it is not fit for the new changes. The
transformational leader can change the behavior of people and nurses during the job period what
they were earlier following during their jobs. A leader can implement the changes and influence
and motivate people to adopt the change with changing their attitude towards the change. For
example, implementing a new technology always create problems to operate and people thus
resist. A transformation leader can change this behavior and nature of nurses and influence them
to use the new technology and enhance their performance for the organisation (Silver,
McQuillan, Harel, Weizman, Thomas, Nesrallah, & Chertow, 2016).
Conclusion
In conclusion, the role of transformational leader in the healthcare organisation is so
crucial as it helps to improve the organizational performance as well as enhancing the individual
performance. As people have nature to resist the change and ignore the innovation and
technological aspects in the organisation, a leader can motivate the people towards the change
and influence them to adopt the change to improve the organizational performance and their own
individual performance as well. The clinical handover is also required so many changes in the
healthcare industry as nurses and staffs are lacking in proper communication and coordination.
Problems related to inefficiency in information sharing and properly sharing the responsibility
are two major causes that creates problem in the healthcare organization. However, the Kotter’s
eight step change process in the healthcare organisation can help the nurses to improve their
performance by adopting the change and changing their culture of work.

Transformation Leadership in Healthcare 10
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