Leadership and Management in Healthcare: Theories and Practices

This report provides a comprehensive overview of leadership and management within the healthcare sector. It begins by defining leadership and its importance in guiding healthcare professionals towards shared goals, emphasizing the need for leadership theories tailored to healthcare, rather than business models. The report explores various leadership concepts, including emotional and social intelligence, ethical leadership, and strategic leadership, highlighting their significance in fostering effective patient care and organizational success. It then delves into management theories applicable to healthcare, such as attribution theory, evidence-based management, and utilization management, alongside project management principles. The report also examines critical aspects of quality service development, including creating a safety culture and clinical governance, and concludes by discussing the challenges and opportunities in healthcare leadership.

Running Head: Leadership 1
Leadership

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Introduction:
Leadership is referred as concept which defines the behavior of person while directing a group
towards a shared goal. The most important feature of leadership involves influencing group
activities and dealing with the change. The biggest issue faced by the healthcare professionals in
context of leadership is that maximum theories related to the leadership are developed from
business point of view and not from the health care point of view. In other words, theories
developed in business context are also used for the healthcare purpose. Published researches in
this context provide very few evidences related to initiatives in leadership that are allied with the
improvements occurred in the patient care or results related to the organization at the time when
they are applied in healthcare setting (Garman, Brinkmeyer, Gentry, Butler, Fine, 2010).
It must be noted that leadership theory is dynamic in nature and changed with the time. The early
great man theory stated that different individuals have different factors that make them good
leaders. Different behavioral theories were developed between the year 1940 and 1980 which
also describe common leadership styles such as authoritarian, democratic and laissez-fair.
Situational and contingency theories were also developed between the years 1950-1980, and
these theories documented the significance of seeing the needs of the employees, the task to be
performed, and the situation or environment (Sawai, 2013).
Interactional leadership theories mainly focus on influence within the particular organizational
environment, and the interactive leadership skills of the leader with the follower. This theory is
based on the organizational behavior studies which further stated if people have supportive
leaders who support them at personal level then such peoples are happier.
Healthcare bodies include numbers of professional groups, departments, and specialties with
complex and nonlinear connections between them. It must be noted that complexity of these
systems is generally unequaled because of the constraints related to the different disease areas,
multidirectional goals, and multidisciplinary staff. Within these health care systems there are
number of groups which belong from different cultures might provide support to each other or be
in fight with each other. Leadership needs to be capitalizing in these health care systems in
efficient manner for the purpose of ensuring efficient utilization of resources while designing the
process of management and for encouraging the personnel to work towards the common
objectives. There are different leadership approaches which can be used by the healthcare

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systems for the purpose of improving the management in this highly complex environment
(Garman, Brinkmeyer, Gentry, Butler, Fine, 2010).
This report discusses the leadership and management within the healthcare sector, and for this
purpose we define important concepts from the leadership and management field which also
includes followership. Lastly, paper is concluded with brief conclusion.
Leadership theories and their applicability in healthcare systems:
Leadership concepts:
Nursing is considered as noble profession which requires selfless leadership, and the duties of
nursing leader include ensuring the highest regulations and standards of patient care by
managing the human and financial resources in effective and efficient manner. The main concept
of nursing leadership includes commitment, vision, and direction. Good leaders conduct such
actions which inspire their followers in positive manner.
It must be noted that the prime objective of leaders in health care systems are ensuring such
sustaining cultures that ensure high quality and compassionate care for patients. As per the
results of one research, for the purpose of achieving this target five key cultural elements must be
present and these elements include:
 Leaders must inspire their visions which are operationalized at each and every level.
 Leaders must provide clear objectives to all the team members, departments, and
individual staff.
 Must ensure supportive environment and also high level of staff engagement.
 Leaders must ensure inclusion of learning, innovation and quality improvement in the
practice of all staff members.
 Effective working of the team (West, Lyubovnikova, Eckert & Denis, 2014).
For the purpose of ensuring high quality of care, there must be direction, alignment and
commitment to be shared. Leader also ensure holistic view of care which also includes
commitment for the purpose of improving linkages with other providers in the system and also
for achieving the main objectives of the system such as continuity of care (Woods, Baker,

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Charles, Dawson, Jerzembek, Martin, McCarthy, McKee, Minion, Ozieranski, Willars, Wilkie,
and West, 2014).
Above stated research further stated that leaders related to the best performing health care
systems prioritized a vision and also develop strategic framework for the purpose of focusing on
high quality and compassionate care. In these healthcare systems, different leaders clarify that
high quality compassionate care was the main and priority purpose of any health systems.
Various evidences are present which stated that such arrangement has an important influence for
the purpose of reducing the effects of faultiness, and this is defined as difference occurred in
group and status that interfere with the effective collaboration. This is a very common issue in
the health care systems (Bezrukova, Thatcher, Jehn, Spell, 2012).
Another important target for health care leaders is job satisfaction of their employees. When staff
of the healthcare system of the organization reported that they are completely satisfied with their
immediate supervisors and patients reported that they are treated with care, respect, and
compassion then such supervisor is considered as effective leader.
Emotional and social intelligence:
Emotional and Social intelligence (ESI) is the approach with correlates with the ability of the
person in self-awareness, self-management, social awareness and relationship management.
These skills facilitate the understanding and managing of social importance. If leaders in the
health care system adopt this approach then they get separate benefit related to their positions.
This approach also helps the leaders to make emotional bond with their employees and patients
while mentoring and coaching their team members (Cummings, MacGregor, Davey, Lee, Wong,
Lo, Muise & Stafford, 2010).
Competencies related to this approach generally consider those factors which separate the
average leader from the great leader. However, ESI of the person improved with the time. In
other words, it can be said that thoughts and feelings of the person are important in allowing us
to influence others (NLP, n.d.).
Leadership ethics:
Ethical leadership is the approach which mainly concentrates on the approach of the individual
provider–patient relationship. However, delivery of patient care becomes predominant in team

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based and integrated across provider organizations. It must be noted that, these ethical
frameworks of the health care system must consider micro- and macro-factors within the system.
The broader issue in this context requires managers and leaders to supplement their ethical
approach beyond the current and prospective patients. In other words, leaders must consider
team, organization, and broader system of the organization where high standard of coordination
and oversights are essential.
Administrators of the health care are also accountable towards the patients only but they are also
accountable towards the team and system. They are under obligation to ensure how system is
organized for the purpose of delivering and ensure quality care for patients (Ho & piney, 2016).
Strategic leadership:
That healthcare entity which has complex system then even easiest term is getting more complex
while handling. In this situation, it becomes difficult to manage the system in effective manner. It
must be noted that in context of international dimension now health care entities which are
considered as ordinary service sector, are now gaining more professional approach. Terms such
as rights of patients, quality, etc are considered as important point of present health care
institutions. Those health care entities which want to keep up with the time must ensure that their
leaders have competencies and elements of strategic leadership. Strategic leadership is the
concept which not only ensure effective strategic framework for the organizations, but also
ensure efficient use of resources for maintaining framework (Budak & Kar, 2014).
Roles of management in the health sector:
Management theories:
Healthcare entities are considered as growing field, and as estimated by the U.S. Bureau of Labor
Statistics job market in context of healthcare managers will grow by 16% in 2018. Health care
managers have various important obligations such as administration of complete health care
systems such as hospitals. Effective leadership in the healthcare entity depends on the type of
management theory implemented in the organization. Some of these management theories are
stated below (Lewis, n.d.):

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 Attribution theory is the way through which managers assess the success and failures of
the health care systems and programs. As stated by the Patrick Palmieri and Lori
Peterson's (2009), for the purpose of building safer health care system manager can use
this theory because it ensures safer environment for the patients. However, this theory
cannot be considered as fully developed management theory in context of health care.
 Another important management theory in context of healthcare is based on evidence
(evidence-based management). As stated by the K. Walshe and T.G. Rundall
(2001), managers of healthcare slowly accept and apply similar theories from
which they generally handle healthcare workers. This is the theory under which
different professionals such as doctors, nurses and other healthcare professionals
make decision on the basis of basis of best available evidences.
 Third and last theory is the utilization management. This theory gets wider application in
the industry of health care in comparison of other theoretical approaches. This is the
approach which ensures management of healthcare institute through preset or predefined
guidelines.
Project management:
From many years, healthcare industry is engaged in the projects, but managers of this industry do
not use any formal techniques for managing the projects. Now, these managers realized that for
remain competitive, they must develop such skills through which they select and manage the
projects in effective manner. Managers must realize that there are number of concepts related to
the project management which help them in working with people daily basis (Bolman & Deal,
2003). Some advantages related to project management are stated below:
 Project management ensures best control in context of human resources, physical
resources, and financial resources.
 It helps in improving the relationship with the customers.
 It takes short time for developments.
 It helps in reducing the cost related to the project.
 Project management ensures high quality and increased reliability.
 It also provides higher profit margins.
 It improves productivity in the health care entity.

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 Ensures better internal coordination.
 Boost up the morale of the workers.
 Reduce the stress level.
Additionally, project management in health care entities ensure other programs such as
embracing program and portfolio management for the purpose of meeting the requirements of
the organization(Kathy, 2013 ).
Quality service development and improvement change:
Creating a safety culture and establishing a constructive climate:
A strong safety culture in the health care entity help the managers in reducing the medical errors,
and it also encourage the leaders of the hospitals to take responsibility in context of patient’s
safety. However, leading researches related to healthcare safety stated that few chief executives
of the healthcare put the patient safety in their prior objective list and also allocate sufficient
resources for improving safety level in the organization. At the same time, it is necessary for the
leaders of the healthcare to learn how they can improve safety leaves in the entity. Strong safety
leadership includes six important characteristics and all these characteristics are stated below:
 It is necessary to set and clearly communicate the vision of the entity in context of safety.
 It is necessary to value and empowered the human resource of the entity.
 Must engage actively for the purpose of improving safety of patients in the organization.
 Must lead by the example.
 Manger must focus on the issues related to the system.
 Organization continuously searches for the purpose of improving the opportunities
(Singer & Tucker, n.d.).
Clinical governance - myth or reality:
Clinical governance is considered as a system through which healthcare entities are accountable
in context of ensuring continuous improvement of the quality of the services provided by them
and also ensure high standards of care related the patient safety. In other words, they are under
obligation to develop such environment which ensures excellence in care provided by clinics.

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It is an umbrella term which mainly covers those activities which help the healthcare entity in
sustaining and improving patient care. Nursing staff may already be familiar with these activities
and also ensure quality and safety improvement. It is the duty of healthcare organizations
towards the community that they conduct such practices and activities which ensure quality and
safety in the system. No matter which approach is adopted by the organization, they must
provide evidences that standards adopted by them are high. There are number of factors related
to clinical governance and this mainly includes activities related to the quality improvement, risk
identification and management, etc. As defined in the report issued by WHO, clinical governance
divide the quality issues in 4 major areas (Crook, 2002):
(1) Efficient use of resources in the provision of health care.
(2) Manage the risk effectively which results from the service provided by the healthcare.
(3) Satisfaction of the patients while providing the service.
(4) Professional performance review (WHO, 1983).
Quality service – concepts and tools:
Necessity in context of quality and safety improvement initiates pervades of health care. Quality
for this purpose is defined as the concept under which services related to health in context of
individuals enhance the chances of wanted health results. Following are the tools which can be
used by the leaders for the purpose of providing quality service to the patients:
 Advanced Implementation Quality Planning- this tool is used for the purpose of ensuring
advanced services in the department.
 Affinity Diagram- this tool is used by the organization for the purpose of generating,
organizing, and consolidates information related to a product, process, complex issue, or
problem.
 Application of 5S- this new application helps the members of the team to develop a new
enrollment template for the purpose of providing services.
 Control plan- last but not the least, this is the plan which state written summary of
actions, resources, and other requirements for the purpose of ensuring that process is
followed properly (ASQ, n.d.).

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Maximizing Organizational Performance:
Productivity and efficiency Effective:
Leader is also under obligation to frame such strategies and conduct all the operations of the
health care system in such manner as it ensure effective productivity in the organization nada los
ensure reduction in production cost. In other words, leaders of the health care systems are not
only liable towards the patients and their only job is not only taking care of the patients, but they
are also liable towards the organizations also.
Inter professional teamwork:
Inter professional team is the means through which different professional of healthcare with
diverse knowledge skills and talents work together for the purpose of achieving common goal.
Leaders have opportunities to get best results for the healthcare by promoting coordination,
collaboration, communication and decision making for the purpose of achieving best healthcare
outcomes. This factor also increases the profitability of the organization and helps them in
getting competitive advantage.
Empowerment and engagement:
Patient empowerment can be defined as approach which inspires the patients to take active
participation in health services provided to them by the health providers. The main purpose of
authorizing the patients is to aid the patients in developing self-awareness and self-care and also
promote the understanding that patients can be equal partners in their healthcare decision. This
approach helps the leaders to promote the patient empowerment and engagement of patients in
the decisions taking by healthcare entity. This increases the entity profitability and increases its
reputation among patients.
Problem solving and decision-making frameworks:
This is the most important area and it directly affects the performance of the organization.
Therefore, there is need to prepare such framework and policies which not only resolve issues
but also help the entity in making the decisions of the organization.
Conclusion:
Leadership in health care organization is an approach which not only manages the work
environment of the organization but also ensures safety of patients in the entity. Prime objective
of leaders in health care systems are ensuring such satisfying values that results in high quality
and concerned care for the patients. It is necessary for the leaders of the healthcare to learn how
they can improve safety leaves in the entity. That leaders related to the best performing health

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care systems arranged a dream and also develop strategic framework for the purpose of focusing
on proper care.
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