Leadership Theories: Shared vs. Transactional in Healthcare Setting

This essay critically compares shared and transactional leadership theories, evaluating their respective values and behaviors within a healthcare context, specifically focusing on the Tamale Teaching Hospital in Ghana. The introduction establishes the importance of leadership in healthcare, setting the stage for an analysis of each leadership style. Shared leadership emphasizes collaborative decision-making and employee involvement, while transactional leadership relies on supervision and rewards. The main body delves into the advantages and disadvantages of each style, including how they align with the values of integrity, wisdom, and respect. The essay highlights the application of these theories in the Haemodialysis unit of the hospital, suggesting that shared leadership, with dimensions like leading with care and engaging the team, can foster better coordination and employee performance. The analysis also examines the alignment of these leadership approaches with Ghana's healthcare policies and the UK's five-year forward plan, emphasizing the significance of preventive measures, community engagement, and effective healthcare management. Finally, the essay touches on motivation theories, such as Maslow's hierarchy, to further understand the dynamics of leadership within a healthcare setting.

CRITICALLY COMPARE TWO
THEORIES OF LEADERSHIP AND
THEIR RESPECTIVE VALUES AND
BEHAVIOURS THAT CONTRIBUTE
TO THE ROLE OF A HEALTHCARE
LEADER

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
SUMMARY.....................................................................................................................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Leadership plays vital role in setting a roadmap for the organisation or people working
under one individual. It assists in deriving appropriate path and order which is beneficial in
serving high quality services and delivering successful performance. The report will outline the
leadership theories and style which assist the health care centre in implementing effectiveness
and efficiency in care services. Thus, it will evaluate the appropriate leadership behaviour and its
dimensions in Tamale Teaching hospital which is Ghana.
There are various types of leadership theory in which two are most effective and related
to regular changes that is hared and transactional leadership theory.
Shared leadership: In shared leadership style there is one person who is decision make
and governs all the individual's working but al the workers are involves in decision making
process (Zhou and Vredenburgh, 2017). It is generally followed in schools where principles are
the decision making authority but all the teachers, students and their families participates in
decision making process. In accordance to this theory it provides various advantages such as, it
is the best style which assist the governing body in making innovative decision and creative style
of leading (Lambert, 2012). Further, it assists in making sensible decision keeping in mind the
interest of all individual's ho are involved in decision making process. It is the style which helps
in serving job satisfaction and empowering employees. However, it has few disadvantages which
are, it is very difficult to manage large number of people and their decision at one point of time.
Further, in accordance to this style the structure of organisation keeps on changing according to
leader decision which is influenced by large number of people. Moreover, if the decision is
taken according to many workers than nit effects effectiveness of decision (Wang, Jiang and Ma,
2017). Nevertheless, there are few disadvantages of transactional leadership style that is
sometimes management end up making ineffective decision due to employee participation and
due to lack of communication which be caused due to language barrier and interaction skills
(Timmins, 2015). According to author, it has been argued that this style of management involves
all workers in decision making process which is the best way to analyse the needs and wants of
individual working at lower level(Ham, Edwards and Brooke, 2013). Some people believe that
involvement of employees in decision making is partial because the ultimate decision is taken by
higher authorities that is top level management (Nazarpoori, 2017). Thus according to author it
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has been stated that the style has it own benefits for organisation like, educational institution,
health care like in this worker's productivity is high (Ham, 2011).
Transactional leadership: Whereas in transactional leadership style is based on
supervision and managerial skills where the leader believes on two factors that is punishments
and rewards. It is the formal type of leadership and in this the leader work under strict practices.
According to author, it has been argued that this style of leadership sets strict regulation for
workers which leads to negative motivation, low morale, frustration, conflicts and inefficiency in
performance (Ham, 2011). However, some people believe that transactional style of leadership
helps the leaders an organisation in making effective and quick decision but according too few
people it has been argued that is the style which aims at providing satisfaction to supervisors and
managers but not to employees (Delegach, Kark and Van Dijk, 2017). There are various
advantages of leadership style that it assist the management in taking effective decision increase
of critical in urgent situations. Further it is beneficial in maintaining discipline at work place.
The major advantage of style that in this the management do not have to changes in structure
again and again which helps in maintaining the continuity of operations. Apparently, style has its
own disadvantages that is the participation of employees and subordinates is being ignored as in
this decision making is based on market conditions. The style do not work when the leader need
to making innovation in decision as per the changes (Ham, Edwards and Brooke, 2013).
Apparently according to author it has been argued that its is most effective leadership style as it
do lead to biased solutions and decision in any case. Whereas some people believe that it
establishes strict working conditions for workers which hamper the working productivity of
employees. Hence, as per some scholars it is the best style which provides easy approach of
managing employees and their work related issues (Basri, Rashid and Samah, 2017).
In contrary, there are some similarities and dissimilarities between shared and
transactional style of leadership that is the ultimate decision making power is in the hand of top
level management, the decisions are centred under rules and regulations of an organisation in
order to protect the interest of every employee working with firm. Dissimilarities are like, in
shared style all employees are involved inn decision making whereas in transactional there is no
involvement of workers in making of decisions (Bass, Avolio and Berson, 2013). Furthermore,
the decision taken by shared style are highly productive while decisions of transactional style are
comparatively less productive (De Hoogh, Den Hartog and Koopman, 2015)
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MAIN BODY
Theories and style of leadership focuses on the values in leader like, integrity, wisdom,
humility, courage, respect, etc. However, implementing leadership theories and values at the
level of nurse in charge of Tamale Teaching hospital which is Ghana in its Haemodialysis unit
plays a crucial role as in this situation the health practitioner are responsible for serving
appropriate and effective services to serve users. Therefore, implementing the best values and
leadership theory act as tonic. Implementing the shared style of leadership is the best tactic
which assist the in charge nurse can involve all, one or more effective nurses in decision making
process (Ham and Harley, 2013). In this the leaders analyses the needs and wants of nurses
which will assist in formulating services according to needs and wants of junior nurses working
under in charge nurse. The health practitioner focuses on discussing every problems of other
nurses to make them realize that the health care centre is bothered about the needs and wants of
staff and not just on maximizing profits. The leader follows shared style of leadership where
every employee is allowed to share their opinion about the work practices (Coulter and Collins,
2011). It is a important for the in-charge nurse to set policies in health care centre keeping in
mind the interest of all the other nurses working under them (Coulter and Collins, 2011).
Setting of Haemodialysis unit in Tamale teaching hospital, Ghana
In this, the nurse will make sure that every practitioner is getting chance to share their opinion
and the functions in Haemodialysis unit are segregated according to the skills and capabilities of
nurses. Further the setting will directly connect practitioner to in charge nurse to make sure that
is there is no communication gap.
In accordance to Tamale Teaching hospital and health care, the health care leadership
model has 9 dimensions which provides the clarity of functions to all the healthcare practitioners.
According to author, the nine dimensions of model assist in determining the effectiveness and
efficiency of workers performance (The Nine leadership Dimensions, 2015). The nine
dimensions are, inspiring shared purpose, leading with care, Evaluation of information,
connecting our service, Sharing vision, engaging the team, holding to account, Sense of
responsibility, Developing capability and influencing Hence, according to shared style three
dimension which can assist Tamale teaching hospital with haemodialysis unit are, leading with
care, sharing vision and engaging team. Further, with the help of theses three dimensions In
charge nurse will be able to traine nurses to serve health care services as one common purpose.
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Further, it will assist in charge nurse in analysing the basic needs and wants of health
practitioners which will assist in improvising their performance (Ross Baker, 2011). However,
these three are best dimensions which will assist leader in establishing coordination ad
cooperation between activities of health care practitioners in Tamale teaching hospital. Thus, the
dimensions plays vital role in relating and managing the activities of employees altogether.
Sharing vision is the dimension which assist the person in formulating the effectiveness of
employees work in one common direction (Ham, Edwards, and Brooke, 2013).
Apparently if the hospital will choose shared style than it will be focused on three
dimension that is leading with care, sharing vision and engaging team as in this the ultimate
decision is based on making employees work as per decision taken by top management. Whereas
as per transactional style two dimension are leading with care and evaluation of information are
considered where only managers are responsible for making decision without participation of
employees (West, 2014).
The health care policies of Ghana are focused on serving improved quality of health care
services is managing health care resources and provisions to provide effective care and
developing effective practices to serve satisfactory health care services in Ghana. However, the
functions of polices is to formulate strategies and technical guidelines serve quality health care
services (Awoke and et.al., 2017). To undertake effective administration and management of
overall Ghana health cares services, To promote healthy measures of living that goody healthy
habits of regular life. Further, the policies aims at establishing effective system for preventing
diseases in Ghana. Moreover, to analyse changes in health care services of Ghana, to provide
adequate training and development to health care practitioners for educating health care
(Amoakoh and et.al., 2017). Hence, to promote effective management functions to promote and
protect the people of dangerous health diseases (Akazili, McIntyre and Ataguba, 2017).
The five year forward review of UK has a strong link with Ghana health care plans
because the five year forward of UK is focused on getting serious about the prevention measures
for health care practices and dangerous diseases where the country focuses on targeted
prevention, follows the shared leadership style in health care centre, supports the employment of
people and ensures workplace health of workers. Further, the forward plan of UK aims at
empowering patients by providing effective health cares services and by promoting effective
healthy living activities among people which is quite similar to the health care policies of Ghana.
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In UK plans, the health care system focus on engaging communities in health care system to
prevent society form dangerous diseases which is also similar to the health care services of
Ghana. Apart from this the forward of UK is focused on managing network of care, serving
health care services out of hospital, effective and integrated services around service users and
introducing new and effective health care models to improvise health cares services.
Apparently, There are various motivation theories stated by various authors which assist
the person according to structure and situation of organisation like, Maslow hierarchical theory
of motivation which is proposed by Abraham Maslow in 1943, where the author believes that the
best way to motivate employee is to fulfil their basic regular needs where it specified some needs
that is self actualisation in which employer focus on intellectual needs, attaining targets and
fulfilling potential like employee's growth and experience with organisation. Further, it focuses
on self- esteem needs of workers where the best strategy to motivate staff treat them with
respect, provide them freedom to work and speak for their rights. Moreover, it helps in
motivating workers as it is focused on status and individual strength at work place. Apart from
this the hierarchical theory involves love and belonging needs of individuals which comprise
sense of friendship, intimacy, family that is sense of connection with the environment and
colleagues with whom the individual is working. In addition, the motivation theory involves the
fulfilment of safety needs in which employees focuses in providing job security, personal
security, property and health safety to staff members which is the best strategy of boosting
employees performance. Thus, at last the theory focuses on most important needs of workers
which is physiological in which the organisation aims at providing basic facilities to workers that
is safe, air, water, food, shelter, clothing. In accordance the Maslow hierarchical theory is related
to Vroom's expectancy theory which states the basic expectation of employee from organisation
which is self actualisation, self esteem, love, food, shelter and psychological needs (Heneman
and Schwab, 2012). However, The Hertz berg theory of motivation is proposed by Frederick
hertzberg which states that serving job satisfaction plays crucial role in improving working
efficiency of workers which can be attained by two factors that is hygiene ad motivation (Dartey-
Baah and Amoako, 2011). In this theory the employer need to maintain the effectiveness of
hygiene factor which comprise, job security, policies and procedure of company, effective
interpersonal relationship of staff, effective supervision, balance in work life and conditions.
Apparently the second factor is motivator for which the management develop the sense of
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achievement among employees, responsibility, opportunity, growth and promotion. These are the
extra factors which helps in boosting workers performance. Thus, the hygienic factors are
focused on workers general satisfaction and assist in preventing dissatisfaction whereas
motivator factor assist high motivation and satisfaction which develops strong sense of
commitment among staff members. Hence, according to heath care sector it has been analysed
that Hertz berg theory of motivation provides the best factors to motivate employees and
managing stable working conditions
SUMMARY
The report summarized the importance and effectiveness of leadership styles and theories
in health care centre. The report found the meaning of styles that is shared and transactional
style of leadership with its similarities and dissimilarities and advantages and disadvantages.
Apart from this it outlined the leading situation of in charge nurse in Tamale teaching hospital in
Haemodialysis unit where the health care implemented shared style of leadership. The report
evaluated motivational theory and their uses to boost employees morale. However, it recognised
9 dimensions model of leadership in health care like Inspiring shared purpose, leading with care
etc. Hence, it discovered that yeas there is link and relationship between 5 year forward of UK
and Ghana health care policies which is focused on providing effective health cares services and
by promoting effective healthy living activities among people.
CONCLUSION
The report introduced two best leadership style that is shared and transactional which are
complete different from each other. In report, for Tamale teaching hospital, Haemodialysis unit
shared style of leadership has been chosen because health care sector is the most sensitive sector
in which it is important for the management to make decision with care after evaluating all the
alternatives which are suggested by health practitioners. Further, as per the leadership style, the
report suggested three most dimension of leadership among nine which are leading with care,
sharing vision and engaging team. Thus, it concluded with use of two most effective
motivational theory that is Maslow hierarchical theory of motivation which aims at fulfilling
basic needs of employees with comparison to Vroom's expectancy theory and Hertz berg theory.
Hence, according to author it has been determined that hertz motivational theory will assist
health care units as it is focused on two major factors that Motivation and hygiene.
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REFERENCES
Books and Journals
Basri, H.H., Rashid, I.M.A. and Samah, I.H.A., 2017. THE IMPACT OF MALAY
TRANSACTIONAL LEADERSHIP STYLE ON EMPLOYEE PERFORMANCE;
THE MALAYSIA'PHARMACY INDUSTRY PERSPECTIVE. International Journal
of Information, Business and Management, 9(2), p.45.
Bass, B.M., Avolio, B.J. and Berson, Y., 2013. Predicting unit performance by assessing
transformational and transactional leadership. Journal of applied psychology, 88(2),
p.207.
Coulter A and Collins A., 2011. Making Shared Decision-Making a reality: No decision about
me without me. London: Kings Fund
Dartey-Baah, K. and Amoako, G.K., 2011. Application of Frederick Herzberg's Two-Factor
theory in assessing and understanding employee motivation at work: a Ghanaian
Perspective. European Journal of Business and Management. 3(9). pp.1-8.
De Hoogh, A.H., Den Hartog, D.N. and Koopman, P.L., 2015. Linking the Big Five‐Factors of
personality to charismatic and transactional leadership; perceived dynamic work
environment as a moderator. Journal of Organizational Behavior, 26(7), pp.839-865.
Delegach, M., Kark, R. and Van Dijk, D., 2017. A focus on commitment: the roles of
transformational and transactional leadership and self-regulatory focus in fostering
organizational and safety commitment. European Journal of Work and Organizational
Psychology, 26(5), pp.724-740.
Ham C , Edwards N and Brooke B (2013) Leading healthcare in London. Time for a radical
response. The Kings Fund. London
Ham C and Harley N (2013) Patient Centred Leadership. Rediscovering our purpose. London
Kings Fund
Ham C, Edwards N and Brooke B., 2013. Leading healthcare in London. Time for a radical
response. London. Kings Fund
Ham C., 2011. The future of Leadership and Management in the NHS. No more heroes London.
Kings Fund
Heneman, H.G. and Schwab, D.P., 2012. Evaluation of research on expectancy theory
predictions of employee performance. Psychological Bulletin, 78(1), p.1.
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Lambert, L., 2012. A framework for shared leadership. Educational leadership, 59(8), pp.37-40.
Nazarpoori, A., 2017. A survey of the effect of leader’s social intelligence on employee’s
perception of interpersonal justice: the mediating role of shared leadership.
International Journal of Leadership in Education, pp.1-14.
Ross Baker G., 2011. The roles of leaders in high performing healthcare systems. London. Kings
Fund
Timmins N., 2015. The practice f system leadership. Being comfortable with chaos. London.
Kings Fund
Wang, L., Jiang, W., Liu, Z. and Ma, X., 2017. Shared leadership and team effectiveness: The
examination of LMX differentiation and servant leadership on the emergence and
consequences of shared leadership. Human Performance, 30(4), pp.155-168.
West M and et.al., 2014. Developing collective leadership for healthcare. London Kings Fund
Zhou, W. and Vredenburgh, D., 2017. 8. Dispositional antecedents of shared leadership emergent
states on entrepreneurial teams. Research Handbook on Entrepreneurial Teams: Theory
and Practice, p.164.
Online
The Nine leadership Dimensions. 2015. [Online]. Available through:
<https://www.leadershipacademy.nhs.uk/resources/healthcare-leadership-model/nine-
leadership-dimensions/>.
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