The Effectiveness of a Quality Leadership and Management Style, Research Proposal Example

Abstract

The research to be carried out is on the effectiveness of a quality leadership and management style that results in improved staff performance. The analysis of the leadership styles will assist in determination of the extent to which managers and leaders in the obstrician  Three facets of these domains were measured, Staff`s job satisfaction, employees competency, and staff reduction. The leader’s competence will also be evaluated and used as criteria for effectiveness and efficiency in the obstician gynecology department. There are considerable correlations between valued real leadership style and capability across circumstances. However, some research has it that alteration affects the style and circumstance on competence for result-oriented leadership character. The outcomes will be regarded as support of the projects analysis of operative leadership being largely universal.

Introduction

The objectives and aim is to study the character tendency on the clinical staff`s job commitment, job satisfaction and staff retention in respect to the leadership oriented style by the clinical manager of the obstrician gynecology department, and performance and quality of service of the clinical staff. The study is of the objective to collect data and solutions to the impending ineffectiveness of the obstrician gynecology department that will be suited in assisting and improving the quality of patient care. Leadership styles of clinical managers determine the rate of clinical staff in the obstrician gynecology department and influences staff nurse retention. The methodology is a cross sectional survey was carried out to illustrate the effects of different leadership styles of the clinical staff working in the obstrician gynecology department. The questionnaire is to be filled by wiling and consented participants among the clinical staff.

The cross-sectional survey conducted was through a target of 15 clinical staff in the obstrician gynecology department aged between 27 and 62. This consists of 2 medical assistants, and 5 Licensed Vocational Nurses. The number of Registered Nurses is 8 of whom 2 have acquired a Master of Science in Nursing (MSN), 3 have a Bachelor of Science in Nursing, while the remaining 3 nurses have associate degrees in nursing.

A period time amounting to 8 weeks will be required for the collection of data. An inquiry will be on the determination of the clinical staff member`s job satisfaction, opinion of their immediate supervisor, and their work ethic. An electronic recording of the data will be carried out to ensure that the IRB standards are met due to increased patient protection and allows for rapid data analysis and storage.

The research procedure will be that the patient`s satisfaction data will be reviewed, an introductory letter containing letter consisting of the IRB standards and a recommendation letter to complete the study will be sent to the obstrician gynecology department for review and approval. The answer coding will be such that an answer of never is represented by 0, sometimes will be listed as 1, an answer of usually will be listed as 2, an answer of always will be listed as 3. In the case of a non-response, the non-response will be listed as 9 to represent this case. The RANDBETWEEN function will be used to hide the identity of the obstrician gynecology clinical staff where their names will be given numbers from the range of 1 to 100.

The generation of correlation coefficient between the employee responses to each question of 0.4 or above is to be considered substantial and merit further analysis. A dichotomized staff response to each question in a secondary analysis will be carried out and student t-tests carried out to compare the mean responses between each group.

This data analysis is of importance in the determination of certain relationship among the clinical staff and the leadership style of the department managers. A positive correlation is achieved when the majority of the clinical staff responses are associated with a particular leadership style. Leaders or managers in the obstrician gynecology department should emphasize on active leadership and in precise task oriented behavior such as description of staff roles and observing of operations to increase quality of patient care. Furthermore, effective leadership styles is key in eliminating the clinical staff incompetency, staff`s job dissatisfaction, and would reduce the rate of staff turnover in the obstrician gynecology department.

The project`s hypothesis, the administrator position is a difficult task that requires leadership and management styles that can be learned. It is of importance that the analysis of the effect of leadership styles and management styles on the clinical staff in the obstrician gynecology department is carried out for the sole purpose of improving the quality of service to patients, increased motivation among staff members to enhance quality and efficiency and also in the reduction of rate of staff exiting the department. The problems of leadership and management styles on the clinical staff and their resultant behavior will prove important in finding the best solutions to the recurrent problems of the obstrician gynecology department and develop a research study eventually.

Problem Statement

1. What is the effect of varying leadership and management styles on the clinical staff in the OG/GYN department?
2. Varying leadership styles affect staff job satisfaction, commitment, and staff retention. Leadership style and management styles are positively related to job satisfaction. Managers in the healthcare organization must adopt suitable leadership in order to improve clinical staff job satisfaction. Varying leadership styles in an organization may lead to staff turnover (Cummings, et al., 2010).

Literature Review

Leadership in healthcare organization seeks to produce necessary changes by developing vision of future and strategies to react to that vision. The ability of a manager to lead affects the ability of staff to achieve stated visions and goals. This part will discuss the literature regarding staff nurse job satisfaction, nurse leader competencies, and staff nurse retention.

A. Job Satisfaction

Job satisfaction has an incontestable influence on clinical staff welfare and their behavior as well. The significant negative relationship between nurse job satisfaction and management styles is well documented in literature. Nurses form the largest occupational group that are employed by hospitals all over the world and this has made them target for cost savings in the healthcare system. Their leaders adopt management styles that are not tested in order to operate on limited budgets. The continuous organizational change in healthcare facilities has led to an overall lack of nursing leadership, which has contributed to increased job dissatisfaction and increased stress. According to Gardulf et al. (2008), nurses become dissatisfied with their work situation when there is no support given to them while developing their profession. The healthcare organizations are competing with each other. Every facility is anticipating improved care, enhanced efficiency, and productivity. What they do not factor in is the satisfaction of the workforce. The management in healthcare facility must create an attractive workplace for the clinical staff in order to reduce the risk of high turnover as well as the loss of vital competences.

Curtis and O’Connell (2011) believe that leadership styles in a healthcare facility affect the quality of patient care. The authors have identified two leadership styles in healthcare unit; transactional leadership and transformation leadership. Transactional leadership is the one, which leaders and employees interact with each other for the betterment of the organization. This type of leadership was not used in the OB/GYN unit and the consequences were that clinical staff were demoralized a fact that compromised the quality of patient care. The other common type of leadership in a healthcare facility is transformational leadership. According to Curtis and O’Connell, this type of leadership enables the organization to achieve greater performance by stimulating innovative ways of thinking. Transformational leaders have vision and can marshal commitment to the vision of the organization. This type of leadership is necessary in managing clinical staff because it will boost their morale thus increasing the quality of healthcare. This type of leadership style was not used at the facility and it led friction between the nursing staff and the administrator.

De Vries, Bakker-Pieper, and Oostenveld (2010) assert that there is a considerable ambiguity regarding the essential behaviors for charismatic and transformational leadership in a healthcare facility. A framework of communication styles affects nurse’s job satisfaction and organizational commitment. Emotional tension, verbal aggressiveness, and argumentativeness are communication styles that can influence leadership styles. Verbal aggressiveness can help nursing leaders to create a motivating work environment. Work environment will always affect employees’ development and their potential. Nursing leaders must adopt a supportive communication style that is linked higher job satisfaction among the clinical staff. The administrator in the healthcare unit adopted a dominant style, which was associated with less satisfaction among the nursing fraternity.

B. Leader competencies

A defined nature of leadership and its relation to employees are decisive factors of organizational performance that depend on organizational commitment, job satisfaction, and performance. Leadership behaviors and styles have profound effects on employees’ job performance and organizational outcomes. Howieson and Thiagarajah (2011) described some ways in which leaders needs to develop in order to gather for the changing organizational and patient needs. Most conflicts in nursing nowadays are directly linked to leadership styles and practices. Leadership characteristics and behaviors are usually associated with personality traits that are learned or natural. Howieson and Thiagarajah further posit that organizations must make an effort to develop opportunities for their members to explore and articulate the knowledge of leadership in complete opulence. The authors argue that clinical leadership has attracted more attention in the recent times because people have been monitoring how the change in leadership styles could bring to the healthcare facility.

In an attempt to describe how leadership is indispensable in the healthcare facilities, Howieson and Thiagarajah (2011) have highlighted that the demand of clinical leadership is increasing considerably. Leadership in healthcare facility cannot be amply understood until the personal traits of leaders are addressed. Efforts to promote and cultivate leaders in a nursing profession empower nurses with the skills needed to pick up healthcare and press forward their profession. Trait and behavioral theories of leadership have tied to make out forms of behaviors and personalities that are associated with effective leadership. In a move to describe the critical factors of personality, Howieson and Thiagarajah (2011) have described the essential levels of conceptualization for leadership. These levels can be viewed as a hierarchy and they include individual, dyadic, group, and organization.

At individual level, leadership approaches is made up of decision-making, motivation, and cognition to elucidate on the behavior of individual leaders. This level also entails the identification of personal priorities and objective as well. At the dyadic level, leadership puts more focus on the pressing relationships between leaders and individuals (normally the followers). At a group level, the main ideas are the nature of leadership role and the manner in which a leader contributes to the group efficiency. Understanding group effectiveness offers crucial insights in relation to leadership progressions and pertinent criterion for assessing leadership effectiveness. At the organizational level, leadership is described as a process whereby large open system becomes subsystems (Howieson and Thiagarajah, 2011, p. 11).

According to Sanford (2011), clinical leaders need human resource management skills since they manage employees. Furthermore, these leaders have to comprehend on the business side of healthcare in order to sustain business goals that may be at odds with quality schemes. Hospital finance leaders look as if they have very little concern while providing safe patient and good working environment of clinical staff. Nursing care is sturdily influenced by the skills of the nursing managers. Managers that exhibit good leadership skills will command respect from the clinical staff and this will enable them to make clinical improvements by spotting the best practices that can improve the quality of patient care. The commitment of healthcare management to the organizational goals will strongly influence the commitment of other employees within the unit. If nurses’ leaders in a healthcare unit will fully support their organizations’ goals and approaches, they will not be needed to build up their leadership skills merely by studying role models.

Nwabueze (2011) asserts that leadership is apprehensive on the management of employees and the accomplishment of organizational goals through the direction of human labor. An effective leader is the one who is capable of motivating and applying the intellectual resources available in a company to achieve set of goals that needs to constantly meet the needs of customers (in healthcare facility the patients). Effective leadership is founded based on consistency. The author describes five traits of leadership that has to be exhibited by leaders in healthcare unit. These traits are dominance, knowledge, self-confidence, intelligence, and creativity. Such leaders must be able to manage themselves as well as people working under them in order for the organization to benefit. The author has gone further to identify three basic skills needed for leadership. The skills are technical, interpersonal, and administrative. Key skills of leadership are processes of expressing and influencing activities of employees related to their tasks. A leader with interpersonal skill of involving other people and the willingness of them to accept directions from the leader may help to confer legitimacy in the organization.

Mohd Soieb, Othman, and D’Silva (2013) argue that idea of employee engagement in an organization is vastly gaining recognition. Involvement and engagement has characteristics that are similar to stickiness and commitment in organizational behavior. When employees are engaged in running the organization, they will be very committed and this will influence others. This will increase the productivity of their work and in return it will enhance the image of the organization; a fact that may escalate organizational profits. The author further argues that employee engagement is a multi-dimensional construct that allows employees to participate cognitively, emotionally, and physically. Employee engagement is seen as including negative result from the employees when leaders adopt classical or transactional leadership styles. When leaders embrace visionary and organic leadership styles, employees will be involved with the running of the organization and this will raise their commitment and in the end enhancing the quality of patient care.

C. Staff nurse retention

According to Cummings et al. (2010), administrators in healthcare units adopt a number of leadership styles with the intent of accomplishing organizational objectives. Such styles have been grouped into two different types. There are those styles that emphasizes on the work of nurses and those styles that puts more focus on the relations of individuals and the organization. Clinical staff believes that their organizational commitment will depend on the kind of leadership adopted in the organization. When the leadership styles isolates them from the key aspects of the organization, their organizational commitment will be diminished leading to quitting. It is therefore evident that interaction with clinical staff in management practices determines their stay and continued working in the facility.

Bae, Mark, and Fried (2010) believe that varying management styles frequently will create unstable leadership in the organization. Unstable management styles will reduce the competencies of the clinical staff. Nurses may become rebellious to certain kind of leadership. This will affect their participation in the organization leading to discernment. The authors argue that role discernment determines individuals’ organizational commitment and the intention of quitting job. When nurses experience role discrepancies and uncertainties in their working environment they will decide to move away in order to better their career development and better working environment. Incompatible leadership styles will create a role disagreement and vagueness and increased role conflict will endanger nurse turnover in a healthcare unit.

Joseph (2007) asserts that one of the most important functions of managers in an organization is to build up the internal and external environment of the organization in manner that can allow them to opt for proper needs of their staff. This will mostly depend on the leadership styles employed by managers in adopting employees’ participation in decision-making. The retention of nursing staff provides the experience needed to offer quality patient care in the ever-changing healthcare environment. Leaders are the key determinants on whether employees will remain in the organization. It is acknowledged that employees do not quite job or organization but rather leaders in the organization. Motivation in the healthcare unit is defined as a product of involvement and contact with the position in which individuals deal with. If employees’ in an organization feel that they are part of the organization, they will perform to their best. If they will not, their commitment will be subjected to question marks leading quitting.

Hypothesis

In order to achieve the objectives of the study, the researcher will test the following hypothesis: the administrator position is a difficult task that requires leadership and management styles that can be learned.

Research Design

A descriptive statistical analysis will be used to illustrate the effects of different leadership styles of healthcare staff working in the OB/GYN department. This study will only be conducted at a single period in time; therefore, it is a cross-sectional analysis to determine the influence of individual leadership styles on staff performance and patient care. Effective leadership will be measured using the quality of both staff commitment and patient care; data including job satisfaction, commitment, and nurse retention will be measured as independent variables based on their administrator’s leadership style.

Role and Biases of the Researcher

A. Role

In a quantitative research, the researcher will be absorbed in the settings involving the study the researcher will therefore be the primary instrument for collecting data. To fulfill this role, the researcher will make available their pertinent aspect such as the knowledge to qualify their capability to conduct the research and expectations from the study. The researcher has the moral responsibility of protecting the rights of the participants and ensures that the research outcome will not have any undesirable and depressing impact on them.

B. Bias

Since the researcher is the primary instrument of the study, it is crucial that the researcher will not only state their roles in the study but also state their biases that might influence the analysis and thus, color the result. The researcher will provide their background information briefly discuss how it might prejudice the research study. As an experienced RN with a good depth of nursing knowledge in the area of Women’s Health, as a clinician and assistant manager, the researcher is conscious of all the challenges that are experienced by clinical staff. Based on this knowledge and experience, it will be natural for the researcher to form personal feelings in relation to the case of the participants.

Sampling Techniques

The researcher will make use of judgment-sampling technique (purposeful sampling) whereby the researcher will opt for the most productive participants to answer the questionnaires. Purposeful sampling technique is appropriate for this study because it involves the development of framework of the variables that are likely to influence the contribution of the participants. This technique is also based on the researcher’s realistic understanding of the subject matter, the accessible literature, and facts from the study itself. Purposeful sampling technique is significant because if the researcher understands the role of the participants, they may stratify them according to known public attitudes. This will enable the researcher to study the subject matter deeply.

Participants

The target population for this study will be defined as 15 clinical staff in OB/GYN department aged between 27 and 62. This comprises of 2 Medical Assistants (MA) and 5 Licensed Vocational Nurse (LVN). The number of Registered Nurses (RN) is 8 of which 3 of them have a Bachelor of Science in Nursing (BSN) and 2 have Master of Science in Nursing (MSN). The remaining 3 participants have associate degrees.

Data Collection Methods

The physical data collection will be conducted over an eight week period. During this time, 15 staff members will be selected from the OB/GYN department and will be approached with informed consent documentation, as appropriate. The researcher will be personally responsible for approaching all 15 participants with a questionnaire that will inquire about the staff member’s work ethic, job satisfaction, and opinion of their immediate supervisor. The survey will be a brief, five question long documents in order to ensure participant retention in the study. The researcher will explain the questionnaire to each participant after they sign the informed consent document in a uniformed manner. The researcher will then leave the participant and follow up with them in an hour; if the questionnaire is filled to the participant’s satisfaction, it will be collected. After the questionnaires are returned, they will be examined in relation to the department administrator’s leadership style. The employees who participate will be assigned a random number and then later matched so the data collected remains anonymous.

After collecting the physical data, it will be captured by electronic means for the purpose of analysis using Microsoft Excel. This will ensure that IRB standards are met due to increased patient protection and it will allow for rapid data storage and analysis.

Instruments

Observation was already used to classify the OB/GYN department administrator’s leadership styles and questionnaires will be used to assess the quality of patient care and the commitment and interest of the staff. The questionnaire will consist of five questions ranked from 1-4 that will assess job commitment, job satisfaction, and the quality of patient care for the staff group. Questions on the survey should be answered using options that include “never”, “sometimes”, “usually”, and “always”.

Research Procedure

The researcher will send introductory and consent letters to the OB/GYN department prior to the study. The letters will include a short explanation about the nature of the research, the researcher’s electronic address for email, and instructions for answering the questionnaire. Patient satisfaction data, collected by the organization and made available to the researcher, will also be reviewed. The introductory letter will contain the standard statement of human subject rights in research and documented permission from the IRB and the university to complete this study in eight weeks. Included will be a pledge of secrecy and confidentiality between researcher and participant. The researcher will draw out demographic information of the participants by assigning them a random ID that cannot be used to trace back to their identity. The researcher will conduct fieldwork alone and be available at all times while in the field for any participant who may have questions or concerns. The researcher will collect the questionnaires an hour after they are distributed. If a participant requires more time, they will have until the end of their shift to complete the questionnaire; after this point the questions that have been answered will be counted towards data for the study and the others will be treated as missing data points. The researcher will enter all data into a computer without assistance and be solely responsible to the validity of the collection and storing of the data.

The questions asked to the patient participants will include: During your experience in this department, how likely are you to agree with your supervisor?, During your experience in this department, how often do you feel you are given the necessary tools/equipment to complete your work in any given shift?, During your experience in this department, how often did you feel that you wanted to find a job elsewhere?, During your experience in this department, how often did you feel you were helping improve patient quality of care?, and During your experience in this department, how satisfied have you been with the leadership style of your superior? In addition, surveyed participants will be asked whether they believe their work is valued by their supervisor, whether they feel they receive the necessary assistance from their supervisor, whether, their supervisor advocates for the clinical staff during challenging situations, and whether their ideas for improving departmental goals are valued.

The supervisor will be observed and classified into one of the ten styles of leadership: autocratic, bureaucratic, charismatic, democratic/participative, laissez-faire, people oriented/relations oriented, servant, task-oriented, transactional, and transformational. The leadership style that enables the employee to feel better about their work and lead to better patient care will be deemed the best kind of leadership for the OB/GYN clinic practice.

Data Analysis

Data Entry

All data will be inserted into an Excel worksheet with the participant’s identity listed in the rows and the number of the question asked listed in columns. Answers to each of the questions should be “never”, “sometimes”, “usually”, and “always”; for simplicity in coding the responses, an answer of never will be listed as 0, an answer of sometimes will be listed as 1, an answer of usually will be listed as 2, and an answer of always will be listed as 3. If the participant failed to respond to the question, an answer of 9 will be listed to represent the nonresponse. The leadership style of the department administrator will also be listed next to each participants name or identifier.

Blinding

To blind the researcher against the identity of the OB/GYN staff who participated in the study and protect against bias, the names of the employees were removed and assigned a random number between 1 and 100 using the RANDBETWEEN function. At this point employee names and all identifiers will be removed from the Excel spreadsheet containing the patient data.

Descriptive Statistics

To determine the pattern of responses amongst the employees who answered the survey questions, the percentage of each response for each question will be calculated. If there is no underlying trend for each question, this information will be dismissed. If there is a significant response pattern, it would be useful to create a bar graph that graphically displays the employee response. Furthermore, the percentage of each response per person will be calculated in order to determine whether the nursing staff surveyed answered questions honestly or just selected the same answer to each question in order to rush through the survey; although all answers will be treated as a part of the ultimate analysis, it will be useful to determine whether the results will be biased. If the results are biased due to this kind of question response, this issue will be treated in the discussion section.

After this primary analysis of the data has been completed, a linear regression will be completed for each question asked that compares the leadership style with the staff responses. All non-responses will be excluded for this particular analysis. The main focus of this study will be to generate the correlation coefficient between the employee responses to each question. A correlation coefficient of 0.4 or greater will be considered significant and warrant further analysis.

A secondary analysis of the data will involve the dichotomization of staff responses to each question. An answer of never will be coded as 0, while responses for sometimes, usually, and always will be coded as 1. Surveys that were returned without an answer to the question will be randomized to either group to prevent against bias. After dichotomization, any event that never happened will be considered 0 and events that happen at least sometimes will be grouped together as well. Student t-tests will be used to compare the mean response between each group. The strength of this association will then be measured using odds ratios.

The main goal of this data analysis will be to determine if there is a certain relationship between the staff response patterns and the leadership style of the department administrator. These tests will all be run a second time to compare the leadership style of the department administrator and the responses for each individual employee.

Interpretation of Results

There will be a positive correlation between staff member response and leadership if a majority of the staff responses are associated with a specific leadership style. The student t-test will be examined by looking at the t value and ascertaining whether the test result is statistically significant p-value. If there is an association determined, the strength of this association will be measured by conducting a test of odds ratio. The p-value will also be examined in this situation. There will be a discussion in this paper that analyzes the power of the study after it was conducted and this will be used to determine whether enough patients were recruited to correctly find a significant effect of leadership in this study. The purpose of this discussion will be to consider whether it would be useful to repeat this study asking the same question using either a different experimental design, a greater amount of participants, or a different cohort.

Addition information regarding patient health status and quality of care may be retrieved from the records. If so, a multivariate regression of this analysis will be conducted to determine the association between leadership style, employee response to the questionnaire, and patient health and quality of care.

Conclusion

The judgment technique used in determining a performing individual would better be replaced by an alternative approach that is of minimal bias to the researcher. It is a complicated process in drawing up a questionnaire that will depict a clear model that is free of favoritism. This being the most challenging part in writing required in depth research in the questions that would effectively satisfy the inquiry.

The most intriguing section of the research was when collecting data through the questionnaire as you get to interact with different personalities and individuals of different abilities and ideologies, and the complexity of the data analysis was of interest as relationships would be drawn and characteristics of staff behavior determined.

It will be of importance to apply the functionality of this proposal in the derivation of an intensive and extensive research project on the leadership and management styles and its correlation to the clinical staff at the OB/GYN department for effectiveness and efficiency in service provision.