Comprehensive Report: Leading in Complex Healthcare Systems - M01SOH

This report delves into the complexities of leadership within healthcare systems, emphasizing the application of System Dynamics to address challenges and foster innovation. It explores leadership from power, change management, and cultural perspectives. The report examines various leadership theories, including shared, distributed, and transformational leadership, and their impact on healthcare outcomes. It also discusses the implementation of Lean management principles, highlighting the importance of leadership in driving successful transformations. The analysis covers key aspects such as policy resistance, dynamic complexity, and the need for collaborative approaches to improve healthcare delivery and patient care. The report also includes an executive summary and conclusion, summarizing key findings and recommendations for effective leadership in complex healthcare environments.

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Leading in complex healthcare system
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Table of Contents
EXECUTIVE SUMMARY...............................................................................................3
INTRODUCTION............................................................................................................3
WHY SYSTEM DYNAMICS INNOVATION?.................................................................4
A. Power perspective..........................................................................................6
B. Change management perspective................................................................7
C. Culture perspective.........................................................................................7
HOW WILL YOU KNOW IT’S BEEN SUCCESSFUL?.................................................8
CONCLUSION.............................................................................................................11
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EXECUTIVE SUMMARY
Considering health care’s crucial role in wellbeing and transformation of the society, its
provision has been prioritized by almost all the nations in the world. According to
Statistics, most countries have allocated a significant portion of its taxes to the sector of
health care. According to Peters & Tran, (2013, p. 234) In spite of that, health care
systems are still not able to deliver the expectations and people continue to suffer
because the quality of health care services is not up to standards.
INTRODUCTION
The outcome of the good-intended decisions, aiming to transform the operations of the
systems, which has led different opposite outcome, also known as “policy resistance”. It
is, therefore, necessary, to consider more holistic concepts, which not only focuses on
the analytic of a part of the system but also uses all the sub-systems and its inter-
connections. According to World Health Organization (2015, p.25) this can contribute
positively because omitting an action that ought to be a crucial part of the process in a
system it may cause an imbalance in the entire equation. The most applicable concepts
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to provide a solution, in this case, are Systems Thinking, System Dynamics (SD)
methodology specifically.
WHY SYSTEM DYNAMICS INNOVATION?
System Dynamics has an assumption that most challenging situations are caused by
the perception held by human beings that systems are naturally dynamic and complex.
To curb this problem, SD provides a concept that is systematic focusing on the
relationship between the analysis of qualitative and quantitative. Sterman (2010, p.57)
recorded that it is composed of diagrammatic systems inform of feedback channels and
then the diagrams are presented into a software referred to as rigorous quantitative
simulation model where there is a chance to possibly analyze events and repucations of
procedures and actions that were employed.
Considering the fact that health care systems cohabit extensive levels of complexity in
dynamics, SD can be widely employed to analyze them and facilitate the decision-
making process to develop and use more effective processes. SD can intervene in the
following processes which include analyzing various infectious illnesses, their spreading
techniques, the effectiveness of screening programs, developing basic care systems
and identifying factors that await to be eradicated.
WHY IS THIS INNOVATION PROVEN?
One way of bringing down the disastrous impacts of “policy resistance”, is by employing
an effective holistic perception of the challenges such as Systems Thinking. According
to Wang (2011 p. 67) it would be best if at first the decision-makers would be equipped
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with technical know-how of working with systems of various interconnected and
interdependent components. With this, challenges shall be perceived as an outcome of
interactions among the various components of the system and not as a result of the
failure of a particular element. This is one of the importance of Systems Thinking. It
represents timely related system activities and not static "snapshots". Systems thinking
brings together an array of techniques brought about by technologies such as
engineering, cognitive psychology, cybernetics, and computing. Systems thinking gives
the managers a chance to defeat the feeling of hopelessness when they encounter
complex situations. It provides them with the basic tools to analyze, comprehend, and
modify the systems’ functions they want to improve. The interruptions in systems are
caused by a specific complexity: “dynamic complexity” comprehending it is significant in
phase 6 of acknowledging the factors causing the complexity and other benefits of
Systems Thinking as it was recorded by Madureira & Vale (2010, p. 108).
Another factor that influences managers to make poor decisions in complex systems is
that they pay much attention to "detail complexity". It is a type of complexity whereby
the decision is made upon choosing from a wide range of static choices. In such a case
where choosing an option over the others is challenging, the most suitable decision can
be made by applying mathematical modeling and computing as Shtëmbari (2017, p.
297) noted.
However, managers’ failure to manage “dynamic complexity” causes system failure
most of the time. Dynamic complexity occurs in cases where: both short and long term
effects of a specific action differ dramatically, and when the expected positive actions
cause un-expected counter-intuitive outcomes. Comprehending dynamic complexity is a
way of identifying the average points in a system to upgrade its operations and reduce
chances of policy resistance as demonstrated by Roberts (2015, p. 78).
IMPLEMENTATION
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Leadership is a process of influencing the behavior of a person while giving directions
on how activities should be carried out to achieve a common goal, as well as adopting
changes as they come. Leadership is challenging in health care setting because most of
the leadership theories were conceptualized on business foundation then employed by
healthcare. A research by Yukl (2012, p. 57) showed that some leadership techniques
lead to improvements in patients’ caregiving services and organizational results when
used in the healthcare setting.
According to Dubrin (2013, p. 65), healthcare systems are made up of several
professional units, functional departments, and specialized faculties with intricate,
interactions that are not linear; as an outcome of such complex systems end up being
unparalleled. The complexity is also due to differences in constraints related to
diseases, multidirectional achievements, and multidisciplinary employees. In health care
systems and other diversified organizations, with various functional groups related to
subcultures are often in support of each other or disputes. Therefore, Leadership
concepts should focus on diversification of the entire organization and ensure optimal
utilization of resources when developing management strategies that will encourage
staff to work towards the shared goals.
A. Power perspective
1. Shared leadership theory
Several types of research show that different healthcare personnel who have a direct
obligation to their clients are not positively responsive to authoritarian leadership. It is
therefore required to concentrate on effective interactive relationships through
encouragement and delegation of duties. This could be the foundation of effective and
proper implementation of the shared leadership theory within the healthcare setting, as
it supports shared management, continuous learning in the workplace and
enhancement good working relationships as recommended by Bertocci (2009, p. 98).
2. Distributed leadership theory
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Globalization required that initiatives and responsibilities should be distributed whereby
large organizations in the business field have acknowledged this leadership approach
and have become more collaborative. Distributed leadership approach requires 4 key
features which include;
1. sense making - the power to comprehend the rapidly transforming business
conditions and adopting the ramifications of changes in the organization;
2. relating – developing trust-based relationships, equalize advocacy with the
inquiry, and design connections of encouragement confidants;
3. Visioning – ability to come up with visionary development pictures of the kind of
future the employees should work towards.
4. Inventing – when leadership is distributed throughout the organization an ethos
is enhanced as a goal whereby the staff can complement each other's
weaknesses and strengths as outlined by Siedel (2014, p.134).
B. Change management perspective
1. The transformational theory
Wal & Gray (2014, p.323) described transformational theory as an advanced model of
the former approach of transactional leadership which concentrated on supervision,
coordination, teamwork and encouraged that employees would work more effectively if
they had a direction in form of a mission statement designed by an organization. The
theory requires leaders to meaningfully translate the vision of the organization to the
junior staff to unify them and create a collective purpose. A committed leader is
supposed to be visionary, encouraging, motivating and transformational.
C. Culture perspective
1. Collaborative theory
Collaboration is a process that is assertive and cooperative and takes place when
people are working together towards a common goal, as an example of a corporate
form of symbiosis. Collaborative leadership also requires communication between
senior and junior staffs so as they remain informed when making a personal decision
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concerning the organization. Such collaborative communication approaches facilitate
healthcare management by holding conversations among various stakeholders;
exchanging views sharing experiences and views which in one way or another reduces
leverages complexity in a healthcare setting. Persons who hold various offices and
positions should take part in the leadership procedures so as they are actively engaged
invalidation and communication of requirements and identifying modifications in
activities that may be needed when addressing change demands.
Leadership in Collaborative healthcare needs a synergistic working environment,
whereby various parties are encouraged to work as a team to ensure the successful
implementation of practices and processes. Such initiatives enhance comprehension of
cultures that are different and promote integration and interdependency of stakeholders,
when people are working together they are unified by mutual visions and organizational
values thus resulting to a synergistic working environment that can attain results that
are better and significant to the organization in a shorter period of time than the sum of
individual efforts which could take even longer time as summarized by Gray (2016, p.
178).
HOW WILL YOU KNOW IT’S BEEN SUCCESSFUL?
Lean is a management ideology targeting to increasing output for the end-users by
managing waste. Therefore it is a suitable concept for health-care organizations to
conceptualize to improve the quality of their services as well as control costs. However,
the adoption of lean management philosophy in a healthcare setting has failed most
cases because of the lack of skills in lean leadership. Netland & Powell (2016p. 234)
conducted an analysis from a systematic literature research performed by the use of
Medline, Embase and Emerald databases and affirmed some of the Lean leadership
principles from the manufacturing literature were culture improvement, self-growth, and
staff training and also pointed out other particular leadership features like, skills,
attitudes, and behaviors for every principle.
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Another leadership guideline that was identified was that of consumer value. The
analysis contributed to current Lean literature by giving better insights into leadership
needs for Lean adoption in a health care setting. A new leadership framework is
suggested for Lean leadership requirements during Lean implementation. In most
cases, approved Lean principles and guidelines are usually composed of Lean tools
and implementation normally have fewer elements related to cultural transformations
and behavioral changes that are necessary for a comprehensive implementation of lean
management processes. However, leadership can fill the gap that exists between Lean
tools and Lean thinking according to Bhasin (2015, p. 78).
No affirmative conclusions have been made on scientific grounds on the leadership
necessities for Lean implementation as far as health care is concerned. A few essential
principles and techniques of Lean leadership have been raised for the effective
implementation of Lean in manufacturing and other industries. Health care though
differs completely from manufacturing and any other industry from its revenue models,
management, disposal, and structure. It is not yet clear if the approaches in Lean
leadership that are used in manufacturing industries can be applied to Lean transitions
in health care according to Devadasan & Shalij (2012, p. 197).
As various health-care organizations try out Lean transformation, the necessity to re-
define Lean leadership techniques in the health-care setting has become more acute.
Chong & Yong (2017, p.237) conducted research aiming to bridge the gap by using a
systematic literature review on leadership to identify the essential requirements for
effective implementation of Lean management in health-care systems. Thus trying to
answer the question; (what leadership requirements are necessary for successful and
effective implementation of Lean management in health-care organizations?
So far, there has not been a systematic leadership literature review of Lean transitions
in health. Health-care organizations face quite some challenges, which includes;
increasing numbers of chronically ill persons, infectious and environmental illnesses,
and rapidly aging populations, taking in part with the high demand for the best quality
and insufficient funds. Concurrently, health-care costs are going up, partly because of
the increasing prevalence of chronic and infectious illnesses that needs long-term care.
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Also, costly and advanced technologies and drugs lead to an increase in the costs as
Attolico (2018, p. 298) recorded.
Health-care institutions may benefit from lean thinking since it addresses some of its
challenging environmental conditions. Effective implementation of Lean management
helps in time management by reducing waiting times, lowering postoperative infection
rates, reduces mistakes, and raises clients’ satisfaction scores. The initial techniques
and applications of Lean in health care have been thoroughly studied, and leadership
has demonstrated to play a distinctive role in effective Lean employment in the
management of health-care organizations.
Lean leadership in manufacturing companies has been widely researched and has
proved to be of great importance for lean implementation to be successful in
manufacturing industries. However, health-care management settings have different
features and carry its operations differently and in a much different environment from
manufacturing industries. Whereas almost all manufacturing industries garner income
directly from their immediate customers, health-care organizations generate revenue
widely from the third-party payments.
In manufacturing lean focuses on standardized procedures that are developed around
the production of a standardized product while in health care, “the product” is giving
back health, strength, and function to people who are sick. The process of restoring
health to different people suffering from different diseases leads to the complexity of the
processes and huge variance in the necessary procedures. According to Privitera &
Gillespie (2017, p. 69) these factors differentiate the health-care sector from
manufacturing sector hence it needs a different set of leadership principles because it is
unique.
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CONCLUSION
The poor performance of health care systems is due to a lack of proper equipment and
use of inappropriate techniques in analysis. Even though the systems are dynamic and
complex, the techniques and heuristics directing decision-making processes in the
systems do not completely apprehend the effects of the most essential components in
these systems and their relationship leading to the poor performance of health care
setting being observed.
The solution to this challenge is to fully employ the principles of Systems Thinking and
System Dynamics to calculate, analyze, and re-innovate the systems being used in
most healthcare settings in the world. Even though these models have developed a firm
foundation in health care management, there are still greater chances for more
improvement of Systems principles to upgrade health care setting. The first analysis of
the effects of policy modifications in the health system in Georgia showed that the
system under development more dynamic and complex. This creates chances for
application of these systematic models to upgrade its performance and monitor its
structural transformation as concluded by Gisi (2018, p. 45).
References
Attolico, L., (2018). Lean Development and Innovation: Hitting the Market with the Right
Products at the Right Time. illustrated ed. Italy: Taylor & Francis.
Bertocci, D. I.,(2009). Leadership in Organizations: There is a Difference Between
Leaders and Managers. illustrated ed. Kaplan : University Press of America.
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Bhasin, S., (2015). Lean Management Beyond Manufacturing: A Holistic Approach.
illustrated ed. Korea: Springer.
Chong, K. & Yong, . A., (2017). Lean Management: The Essence of Efficiency Road to
Profitability Power of Sustainability. illustrated ed. singapore: Partridge Publishing
Singapore.
Devadasan, S. R. & Shalij, P. R., (2012). LEAN AND AGILE MANUFACTURING:
THEORETICAL, PRACTICAL AND RESEARCH FUTURITIES. illustrated ed. Thrissur:
PHI Learning Pvt. Ltd.
Dubrin, A. J., (2013). Handbook of Research on Crisis Leadership in Organizations.
illustrated ed. s.l.:Edward Elgar Publishing.
Gisi, P. J., (2018). Sustaining a Culture of Process Control and Continuous
Improvement: The Roadmap for Efficiency and Operational Excellence. 4 ed. s.l.:Taylor
& Francis.
Gray, D., (2016). Liminal Thinking: Create the Change You Want by Changing the Way
You Think. illustrated ed. Tokyo: Rosenfeld Media.
Madureira, A. & Vale, Z., (2010). Computational Intelligence for Engineering Systems:
Emergent Applications. illustrated ed. s.l.:Springer Science & Business Media.
Netland, T. H. & Powell, D. J.,( 2016). The Routledge Companion to Lean
Management. illustrated ed. Groningen: Taylor & Francis.
Peters, D. H. & Tran, N. T., (2013). Implementation Research in Health: A Practical
Guide. illustrated ed. s.l.:World Health Organization.
Privitera, G. J. & Gillespie, J. . J., (2017). Patient-Centric Analytics in Health Care:
Driving Value in Clinical Settings and Psychological Practice. illustrated ed. Florida:
Lexington Books.
Roberts, J. R., (2015). Mobile Tech Report 2015: Technology news from 2014 and
predictions and insights about 2015. illustrated ed. s.l.:Mindwarm Incorporated.
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