In health care, the importance of leadership in quality improvement has been assessed several times by different authors. During class, we have discussed several approaches to managing change, quality and service through effective leadership methods. The below advanced leadership overview is designed to summarize my understanding of the roles of different management practices.
Leadership to Improve Quality
Hospices are ever-changing health care units, and I have personally seen the results of effective advanced leadership on the quality of service, patient outcome and effectiveness. The below example is a review of my personal experience When approaching long term hospice care, the training of employees is extremely important. Hospice work needs specific knowledge, skills and approaches, and as the health care organization was recruiting newly qualified nurses to reduce the operational costs, this has affected the quality of care for patients. While all the basic needs of the residents were met, the outcomes and effectiveness statistics, customer feedback and satisfaction survey results were disappointing in 2012. The management had to create a strategy that addressed the issues, improved the quality of care, the specific knowledge of care staff and improve work morale as well. The steps the leadership took are detailed as below.
As a leader of the nursing team, consisting mostly of newly qualified nurses or staff without hospice experience, I soon realized that there was a need for advancing the skills, attitudes and effectiveness of the staff in order to improve quality. While the hospice did have limited financial resources, the number of staff was sufficient. A new evaluation system was introduced in the team that assessed issues regarding performance, quality of care, customer complaints and outcome. The identification of the main issues and gaps in skills or specialist knowledge were identified and the right video-conferencing training was selected in order to improve the quality of service. A one-on-one meeting was held after the team meeting with all the nurses, where they set their own targets for improvements, the leadership addressed the concerns and identified the areas of improvement. After the training (1 hour two times a week for 4 weeks after shift) was concluded, the quality of service, speed of response, customer satisfaction were measured again and improvement was immediately shown.
Leadership Strengths and Emotional Intelligence Findings
Assessing my own EQ (Emotional Intelligence) has helped me with understanding my self-awareness, relationship management approaches and social awareness, which was extremely useful for working in a hospice. While managing staff, I had to understand the frustration of newly qualified nurses as well as the dissatisfaction of regulators and customers under the care of the hospice. Therefore, relationship management skills were needed. Emotional intelligence is one of the skills people in health care industry need to improve, and it is also a great aspect of leadership. Schywe (2009) determines the main role of leadership in health care as creating a safe, high-quality patient care. Further, developing a culture that fosters quality and safety is determined as a main tool for improving service. Despite the low results on my test for IQ, I believe that I managed to work together with other leaders during the process of quality improvement, and a collaboration with the training and quality department resulted in a quick identification of a suitable, effective and low-cost advanced hospice training that did not require a great investment of time and resources. By assessing the main leadership styles: authoritarian, democratic, and Laissez Faire, (Marquis & Huston, 2006) I would have noticed from literature that transformational leadership style; involving stakeholders in making important decisions that affect them would have been needed. (McGuire & Kennerly, 2006). The executing part of my leadership was the strength I identified during the process. I quickly realized that training was the most cost-effective solution that was going to create fast results. The key stakeholders were the training, quality and resources department and I had to negotiate with them throughout the change management process. As the resources of the hospice were limited, there was no opportunity to create in-house training or replace existing nurses with staff who had experience in the same environment. The idea was made reality in just two months and the results were achieved. The training also helped me create a positive environment and culture within the nursing team, as staff felt that they were getting the support they needed. Strategic thinking also influenced my decision as it was cheaper to train existing staff long term than hiring experienced nurses at a higher salary.
Team Building Through Assessing Leadership Strengths
While I have managed to create collaboration with the training and quality department to gain support, I have faced some objections initially. One of the main skills of health care leaders should be building trust and providing a vision.(Kalisch et al., 2010) Knowing my strengths and weaknesses determined by by EQ results, I would focus on reflecting on other people’s point of view and create an evaluating and assessment strategy within the nursing team that is not only providing data but supports individual team members in developing themselves. A vision of quality and improvement could have been communicated better in order to gain more commitment from staff in the beginning. While nurses understood the need for specialized training they would also have thought that the change meant a lack of stability. If I was able to communicate the leadership’s goals that they were going to be kept on, they were being invested into, the morale and attitude of the team could have been further improved. By improving my emotional intelligence, I could have successfully addressed choices and improved teamwork alongside with job satisfaction. (Kalisch et al., 2010) I also could have gained more commitment through involving staff in the decision during the transformational management process. Performance measurement and policy reviews could have been implemented in the strategy, if I built upon my relationship building skills, providing more value for the whole organization as a specialist care team leader in a hospice. Building on my “achiever” profile results, I would have been more considerate of other aspects of the organization, as well as my personal goals and achievements in my leadership area.
Kalisch, B., Lee, H., Rochman, M. (2010). Nursing staff teamwork and job satisfaction. Journal of Nursing Management, 2010, 18, 938–947
Marquis, B., & Huston, C. (2006). Leadership roles and management functions in nursing (5th ed.). Philadelphia: Lippincott Williams & Wilkins
McGuire, E., & Kennerly, S. (2006). Nurse managers as transformational and transactional leaders. Nursing Economics, 24(4), 179-185