Health Care Administration: Management Foundations, Coursework Example

A long-term care nursing director would have many leadership responsibilities. They would provide their employees with training how to adequately track and report the progress of their patients. They would also ensure that their employees are healthy and properly motivated to ensure that their work is effective. An additional responsibility would be to group employees in teams that are effective based on their feelings towards one another, since certain individuals work together better than others.

Management responsibilities would include determining which responsibilities each nurse will have in addition to the hours that they would work. Furthermore, they will be responsible for determining the wages and resources that each employee should be provided with to maximize efficiency. They are also responsible for determining which individuals on the senior staff should manage new employees for both supervision and training purposes, in addition to determining how employees should be trained and to what regularity.

Management and leadership responsibilities overlap when they include ensuring that the designated responsibilities are done effectively. For example, the designation of responsibilities and the “how to” falls under management, while providing employees with motivation to excel is a leadership skill. Ultimately, management involves more of determining how the goal should be achieved, while leadership is necessary because it helps the goal become maximized by enhancing the overall efficiency of the employees. A good manager is also a good leader.

Transformational leadership attempts to create a needed change by motivating others and providing inspiration in a manner that pushes group collaboration forward. Transactional leadership focuses on performance, so these types of leaders focus more on designating responsibilities and ensuring compliance of the employees. Emotional intelligence fits in because it is needed more significantly in transformational leadership. Transformational leaders gain a greater understanding of their employees in order to determine how to motivate them and have them fully commit to their work. Transactional leaders do not need to be aware of emotional intelligence, just the end goal.

The problems that Dr. Grant faces is that the emergency department is highly unorganized, which is contributing to backup and the inability for doctors to see patients in a timely manner. Due to the lack of room available, many emergency cases need to be sent to nearby hospitals, which has direct negative consequences for these individuals. Therefore, it is the responsibility of Dr. Grant who oversees this to determine how best to assess his resources and coordinate them.

The individual-level problem that Dr. Grant must deal with is setting goals in order to determine which actions should be taken by the medical team in order to reduce waiting time. Specifically he states that his goal is having “90 percent of the emergency department outpatients in and out of the emergency department in four hours and having the emergency department be on divert no more than once a month”. This is therefore his specific and measurable goal. It is attainable if he can determine ways to reorganize resources that the hospital has in order to ensure that emergency department patients are seen and assessed more quickly so they may either be discharged or sent to the appropriate ward. The resources are dependent upon the hospital funds, more of which could be acquired by appropriating the budget or fundraising. The time aspect involved “reducing wait times by more than 30 percent within six months”.

The team level problems that Dr. Grant must determine a reasonable solution to is whether he could teach the staff about root-cause analysis, reengineer the triage flow to ensure that patients will be able to see a health care professional sooner, and enable the staff to make minor fixes to the electronic health record systems to improve overall team communication. To do so, this would involve discussing the proposed plan with emergency department supervisors to determine an exact plan, which would make the plan more effective in terms of the time aspect. Furthermore, it would determine designating responsibilities to each member of the team and ensuring that they understand their role in the process, which would improve efficacy.

System level problems would include the ability of the team-members to gain an understanding of the electronic health record system. Since there was a communication issue in the hospital initially, this was likely due to inadequate training or understanding of the system. It is therefore necessary to implement training programs to ensure that all necessary staff know how to properly access and utilize the system. Furthermore, there is a need for Dr. Grant to determine a responsibility hierarchy so that each emergency room supervisor is in direct control of other managers or so that each are assigned to a group of physicians. Once this is done, the work flow can become more efficient. There also must be communication between the emergency room administration and the ambulatory team to ensure that individuals will only be brought to the hospital if there is adequate room.