Application Of Servant Leadership In A Health Care Essay Paper

Application Of Servant Leadership In A Health Care Essay Paper Application Of Servant Leadership In A Health Care Essay Paper According to McConell (2012), the difference in a leader and a follower determines the success of a person regarding leadership. This chapter helps explain the content of qualities and proficiency for healthcare managers to be effective. Once again, effective management skills or certain qualifications enhance a healthcare organization environment. Healthcare managers and supervisors must have the capacity to handle challenges while the organization objectives and regulations may change over a period of time. Effective healthcare management governs the success of a healthcare organization. There are many different skill sets and leadership styles to be effective as a manager. People are interested in knowing what strategies are effective…show more content… Brailer (2005) acknowledges that a sizeable number of citizens receive treatment from multiple providers at a time. Interoperability is a gateway for many business ventures in healthcare to accommodate for patients being admitted in multiple provider organizations. All healthcare professionals, especially managers, must communicate effectively. A good example of interoperability is transformation of electronic medical records, or recruiting physician specialists to operate on a specific procedure (Hellberg & Gronlund, 2013). It is expected that complications must be accounted for while building a strong relationship between healthcare managers and staff. Problems are expected to occur. This is the reason why proper planning is important to healthcare organizations. Healthcare leaders might be concerned with cultural differences that exist in their organization. The problem might be caused by a manager not being involved with the immediate department or working environment. Another reason might be inequality issues that boost poor morale, downgrade associations, and devalue legal rights for healthcare systems operations.Application Of Servant Leadership In A Health Care Essay Paper One of the philosophies that defies a common understanding of leadership is a model known as servant leadership. The paradox is that this model is characterized, inherently, by the desire to serve others through seeking the well-being of followers and providing them with the necessary support to achieve goals. Servant leadership is a mindset that is counter-intuitive to the common understanding that leadership requires the pursuit of power, authority or self-promotion to advance an agenda. As a result, many situations and work environments find that this prescriptive style embodies the core values targeted by healthcare entities.Application Of Servant Leadership In A Health Care Essay Paper Permalink: application-of-s…care-essay-paper / ? Leadership Styles In the leadership world where a continuum of models that include authoritarian, transactional and transformational styles, servant leadership takes its place as an important consideration for situational decision-making throughout all aspects of broad disciplines. Many immediately link servant leadership to faith bases as this philosophy characterizes the model embraced by Jesus Christ, Nelson Mandela, Gandhi and St Mother Teresa. Leadership self-awareness and emotional intelligence (popularized by George and Goleman respectively) are fundamentals taught in leadership and management classes throughout the world. As core values define healthcare entities, so too does the mindset and elements of servant leadership in a profession rooted in caring and empathetic values.As health care organizations face pressures to improve quality and efficiency while reducing costs, leaders are adopting management techniques and tools used in manufacturing and other industries, especially Lean. Successful Lean leaders appear to use a coaching leadership style that shares underlying principles with servant leadership. There is little information about specific similarities and differences between Lean and servant leaderships. We systematically reviewed the literature on Lean leadership, servant leadership, and health care and performed a comparative analysis of attributes using Russell and Stone’s leadership framework. We found significant overlap between the two leadership styles, although there were notable differences in origins, philosophy, characteristics and behaviors, and tools. We conclude that both Lean and servant leaderships are promising models that can contribute to the delivery of patient-centered, high-value care. Servant leadership may provide the means to engage and develop employees to become successful Lean leaders in health care organizations.Application Of Servant Leadership In A Health Care Essay Paper Each leader must dig deep using objective tools such as the Myers-Briggs Personality Profile, DISC, and Gallup’s Strength Finders to characterize the personal self. When coupled with the academic works of leadership experts and management theorists a personal philosophy of leadership is established that define our personal self and approach to this chosen life-path. Model Proposed In 1977, Robert Greenleaf coined the term in his essay “Servant leadership: A journey into the nature of legitimate power and greatness.” The following excerpt from this essay offers a general description of this construct for application in both secular and faith-based organizations:Application Of Servant Leadership In A Health Care Essay Paper The servant leader is servant first. It begins with the natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead. That person is sharply different from one who is leader first, perhaps because of the need to assuage and unusual power drive to acquire material professions…The leader first and the seventy-first are two extreme types. Spiritual and Self Transcendence Abraham Maslow said, “Healthcare is a vocation, a calling, and a profession that draws people who seek to become self- actualized in the management hierarchy defined and popularized by an atheist.” A little-known fact is that self-actualization is not the final rung of his globally accepted pyramid for defining the complete self. Spiritual or self-transcendence are actually used to characterize his realization late in life that there is more to self-fulfillment, a higher purpose defines an ability to become whole and complete. This would be consistent with the calling felt by those who seek out the helping healthcare profession as a chosen career.Application Of Servant Leadership In A Health Care Essay Paper Situation and Culture Sensitive Servant leadership has its place among cultures along the continuum of choices for leaders. A situational template is prudent to frame the healthcare context. Servant leadership may not always be a practical model to embrace. Authoritarian model characteristics must be practically applied in operating and procedure rooms where the physician is the captain of the ship by authority and must command how processes unfold. Similarly, guidance must be provided for task-completion in business operations— some transactional styles (characterized by quid pro quo/tradeoff expectations) or transformational styles (participative with others’ needs first but falling short of the Servant philosophy).Application Of Servant Leadership In A Health Care Essay Paper The reality is that with razor-thin profit margins in an environment of free-fall change and diminished return on investment (ROI), there is often not the luxury of mistake-making or employee associates finding their true selves in day -to-day experiences. Rather, servant leadership can be viewed as a marathon in the race of life –crafted, developed and molded through an individual’s collective education, background and experiences. Faced with uneven quality, lapses in patient safety, pressure to curtail costs, rapidly aging populations, and rising technology expenses, health care organizations are seeking ways to improve quality and efficiency while reducing costs. 1 , 2 Health care leaders are adopting management techniques and tools used in manufacturing and other industries, especially Lean, a management philosophy that focuses on improving processes and eliminating waste to add value for customers. Lean calls for a holistic change in management style and organizational culture, requiring leaders to develop new skills and attitudes and adopt new behaviors.Application Of Servant Leadership In A Health Care Essay Paper Effective Lean implementation requires leadership at all levels of the organization to systematically align Lean philosophy and tools with the organization’s strategic goals, vision, and values. Health care organizations that have implemented Lean comprehensively and systematically have seen improvements in quality, patient safety, and employee satisfaction. 1 , 3 , 4 Yet few health care organizations have achieved sustainable, long-term implementation of Lean. All too often, health care and other organizations attempt to implement Lean via piecemeal application of methods and tools, rather than creating holistic cultural change that promotes involvement of employees in daily improvement and behavioral changes. 5 – 7 The centrality of leadership to Lean initiatives has been widely acknowledged. 7 – 10 For instance, Mann 7 observed that 80% of Lean implementation depends on senior management’s creation of an environment that fosters success. Several authors have described the specific leadership characteristics and behaviors that are associated with successful and sustainable Lean transitions in health care. 7 Characteristics of successful Lean leaders that have been described include empowerment, trust, modesty, openness, and respect for people Application Of Servant Leadership In A Health Care Essay Paper Existing findings suggest that successful Lean leaders use a coaching leadership style 6 , 7 that shares underlying principles with servant leadership. However, despite the apparent synchronicity of the two approaches, specific similarities and differences between Lean and servant leaderships have not been described. We address that gap by performing a comparative analysis of Lean and servant leaderships in health care. To our knowledge, this is the first study to systematically examine and organize the current body of research literature that either quantitatively or qualitatively explores servant leadership and Lean leadership in health care organizations. Leadership has been defined as “a process by which one person sets the purpose or direction for one or more persons and helps them to proceed competently and with full commitment”. 11 A broad body of work on leadership suggests that there are many appropriate ways to lead and that there are many styles of leadership. 12 Some studies examine leadership as a process; 13 however, most theories and studies describe traits, qualities, and behaviors of the person who is considered the leader. 12 A broader view of leaders as cultural change agents has emerged since the 1980s. 14 According to this view, effective leaders clearly identify and address issues related to organizational culture, adapting to change as the environment shifts and develops. Researchers have also identified the following two types of leadership: “transactional” in which leaders motivate employees through consequences and rewards and “transformational” in which leaders motivate followers by satisfying higher order needs and more fully engaging them in the process of the work. 12 , 15 , 16 Both Lean and servant leaderships are understood as types of transformational leadership.Application Of Servant Leadership In A Health Care Essay Paper Lean leadership Lean thinking is based on creating maximum value for the client by minimizing waste and assuring value that is added at every step of all processes. 11 Goodridge et al 17 described the following five key principles of Lean: 1) identify customers and specify value, 2) identify and map the value stream, 3) create flow by eliminating waste, 4) respond to customer pull, and 5) pursue perfection. Employee participation and knowledge are considered central to the Lean organization. 5 Lean leaders are coaches who create the strategy, build the team, and help employees develop their skills. Dombrowski and Mielke 5 described the following five basic principles of Lean leadership: Improvement culture: strive for perfection but view failure as an opportunity for improvement. Self-development: act as role models for others in the organization.Application Of Servant Leadership In A Health Care Essay Paper Qualification: commit to long-term development of employees and continuous learning. “Gemba”: commit to managing from the shop floor and making decisions based on firsthand knowledge. “Hoshin kanri”: work to align goals on all levels, always retaining focus on the customer. Servant leadership Greenleaf’s theory of servant leadership is based on the idea that leaders should serve their followers. 18 – 20 In contrast to leadership theories that focus on the leader’s actions, servant leadership defines leaders by their character and their commitment to serving others. 21 Servant leaders seek to develop a sustainable organization, bring out the best in employees, and serve the community. 21 Laub 22 investigated servant leadership in organizations, defining it as a philosophy in which “the good of those led over the self-interest of the leader”. He identified the following six key areas of an effective servant-minded organization:Application Of Servant Leadership In A Health Care Essay Paper Values people: believing, serving, and nonjudgmentally listening to others; Develops people: providing learning, growth, encouragement and affirmation; Builds community: developing strong collaborative and personal relationships; Displays authenticity: being open, accountable, and willing to learn from others; Provides leadership: foreseeing the future, taking initiative, and establishing goals; and Shares leadership: facilitating and sharing power. In their practical model of servant leadership, Russell and Stone 23 identified functional and accompanying attributes of servant leadership (Figure 1). They defined functional attributes of servant leadership, such as vision, honesty, integrity, trust, service, modeling, pioneering, appreciation of others, and empowerment. The model shows the relationship between the leader’s attributes and the manifestation of servant leadership. Servant leadership is considered as a controllable independent variable that affects the dependent variable of organizational performance. However, several mediating variables, such as organizational culture, social context, and the broader culture, may influence the effectiveness of both Lean and servant leaderships and affect the organizational performance. The model includes all important aspects of leadership in an organization and demonstrates its complexity. We substituted Lean leadership in Russell and Stone’s model and then compared servant leadership with Lean leadership.Application Of Servant Leadership In A Health Care Essay Paper Healthcare is well suited to servant leadership. The alignment between the values fostered in healthcare and the principles of servant leadership combine to achieve compatibility of this model. Caring for others is among the ethical and professional values and is a basic tenet of servant leadership. It is possible to embrace and foster the values proposed in this philosophy, as all healthcare entities convey in their mission. One can realistically find a balance and embrace the core values that characterize this model by applying daily to an affected area as prescribed. Globally, health care systems in the developed world continue to struggle with escalating demands for services and escalating costs. Service design inefficiencies, including outmoded models of care contribute to unsustainable funding demands. 1 An example is the continuing practice in many settings to look to hospital emergency departments to provide what are essentially, primary health care services. While some progress and reforms have been achieved, numerous experts point to the need for further system change if services are to be affordable and appropriate in the future. 2 They note that Application Of Servant Leadership In A Health Care Essay Paper […] further change is still needed, despite years of progress in the quality of health care around the world. This transformation will require leadership – and that leadership must come substantially from doctors and other clinicians, whether or not they play formal management roles. Clinicians not only make frontline decisions that determine the quality and efficiency of care but also have the technical knowledge to help make sound strategic choices about longer-term patterns of service delivery. 2 Effective clinical leadership has been linked to a wide range of functions. It is a requirement of hospital care, including system performance, achievement of health reform objectives, timely care delivery, system integrity and efficiency, and is an integral component of the health care system. 2–4 Though most people are provided with health care within the community setting, hospital care continues to garner the bulk of funding and attract considerable attention in relation to care quality and related concerns. Indeed, hospitals are very costly and diverse environments that vary in size and complexity, determined in part by their overall role and function within the larger health care system. The services provided by individual hospitals are determined and driven by a number of mechanisms, including government policy, population demographics, and the politics and power of service providers Application Of Servant Leadership In A Health Care Essay Paper However, regardless of the differences, the clinical areas of the hospital are critical to all health care organizations, given that it is at this level where consumers principally engage with the hospital system. It is at this point where consumers are recipients of hospital care and where they witness and experience how the system functions, observing the strengths and inefficiencies of the health care system and conflict and collegiality between and among groups of health professionals. It is also at this point that clinicians, defined as any frontline health care professionals, have opportunities to fulfill leadership roles. For consumers of health care to achieve optimal health outcomes and experience optimal hospital care, many believe effective clinical leadership is essential. In this paper, we discuss clinical leadership in contemporary health care, definitional issues in clinical leadership, roles of hospitals in contemporary health care, preparation for clinical leadership roles, and the facilitators and barriers to effective clinical leadership in the hospital sector. Clinical leadership in contemporary health care Application Of Servant Leadership In A Health Care Essay Paper The importance of effective clinical leadership in ensuring a high quality health care system that consistently provides safe and efficient care has been reiterated in the scholarly literature and various government reports. 6–8 Recent inquiries, commissions, and reports have promoted clinician engagement and clinical leadership as critical to improving quality and safety. 9 As one Australian example, a key priority nursing recommendation of the Garling Report was that Nurse Unit Manager (NUM) positions be reviewed and significantly redesigned “to enable the NUM to undertake clinical leadership in the supervision of patients […] to ensure that for at least 70% of the NUM’s time is applied to clinical duties.” 8 The remaining time could be spent on administrative and management tasks. In the more recent Francis report 7 from the UK, a recommendation was made for similarly positioned ward nurse managers to be more involved in clinical leadership in their ward areas. In the United States, clinical leadership has also been identified as a key driver of health service performance, with the Committee on Quality of Healthcare suggesting considerable improvements in quality can only be achieved by actively engaging clinicians and patients in the reform process. 10 However, leadership in health care is often very complex, and some authors claim it faces unique contextual challenges. For example, Schyve 5 claims aspects of governance are sui generis in health care, noting Application Of Servant Leadership In A Health Care Essay Paper healthcare organizations also have a rather unique characteristic. That is, the chief executive is not the only part of the organization’s leadership that is directly accountable to the governing body. In healthcare, because of the unique professional and legal role of licensed independent practitioners within the organization, the organized licensed independent practitioners – in hospitals, the medical staff – are also directly accountable to the governing body for the care provided. So the governing body has the overall responsibility for the quality and safety of care, and has an oversight role in integrating the responsibilities and work of its medical staff, chief executive, and other senior managers into a system that that achieves the goals of safe, high-quality care, financial sustainability, community service, and ethical behaviour. This is also the reason that all three leadership groups – the governing body, chief executive and senior managers, and leaders of medical staff – must collaborate if these goals are to be achieved (Schyve 2009:35). 5 While nursing is not specifically named in the above quote, we believe nursing to be implicit and integral to leadership in hospitals. There is recognition of the challenges associated with health care governance, evidenced by significant investment internationally in building systems for leadership development in health care. 5,11 For example, the UK advanced leadership programs have been instituted and run for clinical leaders since 2001 by the National Health System Leadership Centre, 12 and there are some similar innovations in other countries (see, for example, Ferguson et al 13 ). This points to the realization that the cost and consequences of poor clinical leadership greatly outweigh the costs and potential benefits of provision of formal programs to enhance clinical leadership capacity ideally in a multidisciplinary health care team context Application Of Servant Leadership In A Health Care Essay Paper Indeed, across the health care sector, evidence exists of the need for clinical leadership to optimize care delivery. In addition to challenges associated with resources and demand, episodes of poor patient outcomes, cultures of poor care, and a range of workplace difficulties have been associated with poor clinical leadership, 8,9,14 and these concerns have provided the impetus to examine clinical leadership more closely. Definitional issues in clinical leadership Within the health care system, it has been acknowledged that clinical leadership is not the exclusive domain of any particular professional group. 15 Rather, all members of the health care team are identified as potential leaders. 16 Like “leadership,” the concept of clinical leadership can be defined in a range of ways; and while a standard definition of clinical leadership providing absolute agreement on meaning is not crucial to progress and is likely to prove difficult, 17 it is useful to consider the various ways clinical leadership is conceptualized and presented in the literature. While effective clinical leadership has been offered up as a way of ensuring optimal care and overcoming the problems of the clinical workplace, a standard definition of what defines effective clinical leadership remains elusive. 15,18 Indeed, in some ways it is easier to consider what constitutes poor or ineffective clinical leadership.Application Of Servant Leadership In A Health Care Essay Paper A secondary analysis of studies exploring organizational wrongdoing in hospitals highlighted the nature of ineffectual leadership in the clinical environment. The focus of the analysis was on clinical nurse leader responses to nurses raising concerns. Three forms of avoidant leadership were identified: placating avoidance, where leaders affirmed concerns but abstained from action; equivocal avoidance, where leaders were ambivalent in their response; and hostile avoidance, where the failure of leaders to address concerns escalated hostility towards the complainant. 14 These forms of leadership failure were all associated with negative organizational outcomes. Similarly, McKee et al employed interviews, surveys, and ethnographic case studies to assess the state of quality practice in the National Health Service (NHS); they report that one of the most important insurances against failures such as those seen in the Mid-Staffordshire NHS Trust Foundation is active and engaged leaders at all levels in the system Application Of Servant Leadership In A Health Care Essay Paper Despite the definitional uncertainty, a number of writers have sought to describe the characteristics, qualities, or attributes required to be an effective clinical leader. Synthesis of the literature suggests clinical leadership may be framed variously – as situational, as skill driven, as value driven, as vision driven, as collective, co-produced, involving exchange relationships, and as boundary spanning (see Table 1). Effective clinical leaders have been characterized as having advocacy skills and the ability to affect change. 20,21 As well, effective clinical leaders have been linked to facilitating and maintaining healthier workplaces, 22,23 by driving cultural change among all health professionals in the workplace. 24 To achieve these positive outcomes, clinical leaders need to be seen as credible – that is, be recognized by colleagues as having clinical competence 18,25–27 and have the skills and capacity to effectively support and communicate with members of multidisciplinary clinical teams. 18,25 Taking an individual perspective, effective clinical leaders require personal qualities that reflect positive attitudes toward their own profession, have the courage and capacity to challenge the status quo, effectively address care quality issues, and engage in reflective practice. 18,14 Pepin et al found that clinical competence, the capacity to lead a team, and being prepared to challenge the status quo were necessary skills for clinical leaders in one Canadian study. 28 In an Australian study, findings indicated that student nurses want clinical leadership attributes from their clinical preceptors to include being supportive, approachable, and motivating, while being effective communicators. 29 Table 1 summarizes the characteristics of clinical leadership and the attributes of clinical leaders distilled from the literature.Application Of Servant Leadership In A Health Care Essay Paper Nurses can serve as agents of change in the drive towards better working practice. A model for change to evidence-based practice, systemically asks a clinical question, searches the relevant literature, critically evaluates the evidence, and applies the results to the practice setting was described (Rosswurm & Larrabee, 1999). Many times communication appears to be a simple concept within health care. A lack of quality communication limits the quality of service that can be provided to the patient. Some of these issues are rooted within health care system design, while others are the result of inappropriate services provided to patients (Wanzer, Booth-Butterfiled, & Gruber, 2004; Strawderman & Koubek, 2006). Communication limitations often make the patients’ visits frustrating and unpleasant but since the products of health care systems are services, measuring health care quality must extend beyond clinical measures to also incorporate patient perceptions and experiences (Wanzer, Booth-Butterfiled, & Gruber, 2004; Strawderman & Koubek, 2006).Application Of Servant Leadership In A Health Care Essay Paper Patient safety is dependent on practicing nurses, nurse educators, leaders, researchers, and other healthcare professionals to contributions to the health of patients, nursing education and practice, by discovering and evaluating new strategies for improving healthcare quality for patients and communities can find great value in the new insights and innovations. Knowledge of how to develop, implements, and continuously improve patient safety is currently limited and not accessible to most health care organizations. Health care organizational strategies for electronic health records safety which either affects patient safety directly or indirectly are; care-process transformation (thoroughgoing redesign of health care processes to achieve significant improvements in clinical outcomes, service levels, and costs), patient safety (consistent, organization-wide efforts to improve care quality and patient outcomes), human-factors engineering (fitting technologies to organizational, team, and individual needs), project management (the application of explicit management practices to a project to maximize benefits and minimize costs, including risks) software safety (the application of systems engineering methods to reducing the risks associated with software design and use), continuous improvement (unceasing, systematic efforts to improve processes and outcomes (Brown et al., 2007; Carayon, 2007; Ebright, 2010; Kohn et al., 1999; Walker, 2005). Leadership models can offer increasing knowledge for stability that may be ideal for health organizations to focus control and management of resources, manpower and assets, efficiently. However, a hierarchical form of leadership is not congruent with our current knowledge era marked by the need to build intellectual capital and facilitate knowledge flows, adaptability and learning.Application Of Servant Leadership In A Health Care Essay Paper Nurses who understand the emerging science of complexity will be better prepared to creatively face these issues and improve health in broad and lasting new ways for improved safe patient care, from the start of nursing education programs providing advanced leadership theory content in academic curricula or respective organizational/system leader development programs, and then applying these areas learnt to practice. A survey revealed that healthcare leaders intuitively support principles of complexity science, because, leaders that uses complexity principles offers opportunities in the chaotic healthcare environment to focus less on prediction and control and more on fostering relationships and creating conditions in which complex adaptive systems can evolve to produce creative outcomes (Burns, 2001). Leadership functions will be need to thrive in complexity, the challenge facing organizations by identifying new ideas, interacting with others to generate novel solutions, and building relationships and networks. Policy-making initiatives will be vital for these successes, and for providing seamless, affordable, quality care that is accessible to all, with improved health outcomes. The impacts and organizational/ national changes that can occur from policy creation can become extremely beneficial for the healthcare population. As leaders, nurses can work with all groups, agencies, organizations and communities to foster and develop the transformation that is necessary for the 21st century.Application Of Servant Leadership In A Health Care Essay Paper Nurses are often asked to think about leadership, particularly in times of rapid change in healthcare, and where questions have been raised about whether leaders and managers have adequate insight into the requirements of care. This article discusses several leadership styles relevant to contemporary healthcare and nursing practice. Nurses who are aware of leadership styles may find this knowledge useful in maintaining a cohesive working environment. Leadership knowledge and skills can be improved through training, where, rather than having to undertake formal leadership roles without adequate preparation, nurses are able to learn, nurture, model and develop effective leadership behaviours, ultimately improving nursing staff retention and enhancing the delivery of safe and effective care. As

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