What does it mean to be a leader. According to Forbes Magazine, a leader is someone that isnt afraid to take the initiative to act. A leader is not only there during good times, but also in times of need and hardship. Whenever there are big changes that must take place, a leader is never afraid and instead will look at this as an opportunity to improve the old ways. There are many challenges a leader must face, especially in healthcare. Being ready and having contingency plans for every possible situation is what can set apart a leader from the rest.
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The Healthcare Delivery System
The health care delivery system or simply “health system” is a combination people, health care organizations, and all their resources that aim to deliver professional quality care to different target population (Hackbarth, 2009). According to the Institute of Medicine (IOM) on their consensus report, the health care delivery system will need to achieve better performance on the following six dimensions to be improved:
Safety – Avoid doing harm to patients.
Effectiveness – Use of evidenced-base practice instead of unproven methods.
Patient-centeredness – Respect and involve patients in their care.
Timeliness – Treatment given without delays.
Efficiency – Maximizing results with lowest required resources.
Equity – Equality of all people in receiving health care.
The nurse leader can use the previous six dimensions defined by IOM as a guideline in times of change to reform the healthcare delivery system for the better.
Leaders versus Managers
Managers can be leaders but not all leaders can be managers. A person can become a leader based on personality, knowledge, and expertise. A manager is often a position given by a higher authority. Since it is a position that is assigned, it is more stable while being a leader is often only temporary. The main concern of a manager is the goal of the company or the organization. The leader’s main concern is the satisfaction and goals of group members. A leader doesn’t need to have a managerial position to be able to act as a leader. In contrast, a manager often requires leadership traits to function as a good manager (Finkelman, 2011).
The idea behind transformational leadership is to create a leader that can easily adapt to changes and also empower the staff at the same time. This type of leader goes beyond just teaching staff of their role within the organization, but also able to influence others to be independent of their own thinking on how to further improve the organization to the extent of even taking risks (Finkelman, 2011).
The Institute of Medicine (IOM) recommends five core health care profession competencies to use as a framework to focus on improving care. They are as follows:
Care is focused on the patient
Collaborate with other academic disciplines teams
Use of evidenced-based practice
Improve quality application
Use of informatics
With so many changes that need to take place on these five core health profession competencies to improve health care, a transformational leader will indeed be required since such a leader should have an easier time adapting to change. This leader will need to show exceptional knowledge in these areas and be able to apply that knowledge on his practice while empowering others.
Even a transformational leader has its flaws. If such a leader proves to be unsuccessful, it is usually due to one or more of the following errors:
Lack of sense of urgency
Lack of a guiding coalition
Lack of a vision
Lack of communication about the vision
Lack of removals of barriers to the vision
Lack of systematic planning
Declaring a victory to soon
Lack of recognition of organization culture
There are different ways a transformational leader can overcome these errors. For the lack of sense of urgency, a leader needs to have a strong determination to complete the tasks required to finish the job in time. It doesn’t matter how small a step must be taken as long as it leads to moving forward as soon as possible (Kotter, 2008). Lack of a guiding coalition can be resolved by acquiring more information that can be used to set the correct course of action. This can be done by the leader by gathering his team and discussing his findings and plans for the change. The leader should also prepare plans on how to handle communication barriers such as lack of vision, systematic planning, and communication. This plan can involve creating a focus group that will enable team members to voice their opinions and concerns as well as their achievements. This can also be an opportunity to share ideas on how to improve. Using questions that provoke honest answers that can also be used to evaluate how the team feels. No matter how sure a leader is, declaring a victory to soon should be shunned upon. It might raise the morale of the people but the aftereffects of failure or loss will be much more devastating compared to not declaring victory too early. A smart leader will be patient and will avoid making claims without backing it up. Finally, lack of recognition by the organization to its people or employees could cause feeling of un-appreciation-that no matter how much hard a person work, his achievements will never be recognized. One way to solve this by the leader is to form some sort of award system that will recognize employees that excelled in their field. This could be a monthly thing such as an “employee of the month” award or something especial like recognition award of how an employee excelled on something that benefited the organization. Whatever the case may be, it’s a good idea to reward employees that do well. This doesn’t only keep their morale high but also makes them feel appreciated and important which often result in more productivity at work (Entrepreneur.com, 2011).
Competencies of an Effective Leader
The two most important competencies I have selected for an effective leader are as follows:
Work in interdisciplinary teams
The other competencies are also important but both of the above are increasingly becoming more so in our current and most likely future health care system. The health field is composed of several interdisciplinary sciences that each having their own expertise. A kind of leader that doesn’t limit himself to one branch of health care and is willing to collaborate with other professionals is not only wise but puts the leader in a great advantage especially because of the information he can utilize in making good decisions. In my own opinion, being able to know where to get information on how to accomplish what is intended is usually a better trait than trying to shoulder it all.
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Along with utilizing information is informatics-a field in science where information is processed, managed, and retrieved mostly by the use of computers. An example of this is the Health Information Technology (HIT) that will be critical in implementing this system of managing health care delivery (RWJ Foundation, 2011). With the advancement in technology for the past 10 years, it will be unwise for any leader not to learn and take advantage of information technology. Even nursing has a new field now called “nursing informatics” where nursing and computer science meets. Informatics has become relevant to nursing now more than ever. Almost every information known to man are now is being computerized and stored in big computer databases. Even in hospitals, from MARs to TARs, to patient records, discharge plans, care plans, etc. all are being automated and stored in computers. Hospitals everywhere and even other companies have a motto of going “paperless” in the future. It will be obvious to any effective and competent nurse leader that learning informatics is a necessity (Salsali, 2010).
There was a study done in Ireland to find out leadership development needs. The study is done on nurses’ and midwives back in 2009 using a random sample of over 2000 all across different departments and divisions. The purpose of the study is to describe the clinical leadership of these nurses. The leadership needs was measured using a questionnaire called CLAN-Q or Clinical Leadership Analysis of Need Questionnaire that was developed by the people conducting the research. According to CLAN-Q results, there are five main areas of clinical development needs for a leader and they are as follows:
Managing the clinical area
Managing patient care
Developing oneself as an individual
Developing the profession
Skills for clinical leadership
Obviously, a nurse leader needs to learn how to manage the clinical area. This can involve coordinating care and identifying care priorities. Being a patient advocate and protecting their privacy falls down to managing patient care. A nurse leader should also be aware of his/her limits by knowing his/her own strength and weaknesses developing into a better individual. Participating in professional gatherings or seminars relating to one’s own profession can also further develop it. Lastly, empowering others and learning how to adapt to changes are necessary skills for a leader (Casey, 2012).
I believe including the above five areas in manager and leadership development programs will prepare them better in becoming good managers and leaders.
Being a manager or a leader is not an easy task. Not only there are so many things a manager or leader should learn, but also there are a lot that they have to teach others. There are types of leaders that can be good in one department but not so much on others. There are also errors or mistakes a leader can make. But no matter what kind of leader or manager a person is, learning from past mistakes and pursuing for improvement are qualities not only ideal for leaders and managers, but also to an individual.
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