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Leaders

Instructions:-

Interview and Analysis Guidelines

Goals:

  • Apply theories and concepts of leadership to the current healthcare environment
  • Analyze effects of leadership styles, approaches, and strategies on organizational behavior and staff behavior in a specific setting.
  • Analyze the leader’s role in mentoring and succession planning

Guidelines:

  1. Review leadership literature. Focus on evidence-based leadership styles, approaches, and strategies. Summarize and synthesize key findings.
  • Interview a nurse leader who you think has significantly influenced health care. The nurse leader should not be from the agency where you work. The nurse leader should be at least two levels above your current position.
  • Discuss the following topics and support your analysis with the literature.  Based on your interview, describe and analyze the following:
    • The leader’s personal philosophy of leadership/administration and leadership style.
    • Critical events that led to the leader’s personal leadership philosophy and style.
    • How the leader’s personal philosophy and leadership style influences organizational behavior (provide specific examples).
    • How the leader’s leadership style influences the behavior of staff and employees (provide specific examples).
    • How the leader applies evidence-based management / evidence-based decision-making to his/her practice and how the leader promotes evidence-based practice within the organization and among staff (provide specific examples) 
    • How the leader promotes a culture of patient safety and health care quality (provide specific examples).
    • How the leader rewards creativity and innovation (provide specific examples).
    • How the leader develops future leaders (mentoring) (provide specific examples).
    • How the leader plans for succession (provide specific examples).
  • Compare and contrast the information gained during interview with your findings from the literature.
  • Paper should be between 5-7 double-spaced pages excluding reference list, using APA (6th ed.) style and grammar guidelines.  Headings are required and should be consistent with grading criteria. Review use of the personal communication citation in the APA manual.

Note: Please see syllabus for penalties for late papers

Interview answers:  (last question still needs answering)

  1. Leadership is not the job of putting greatness into people, but rather the recognition that greatness already exists. The role of a leader is to provide the grand challenge, create the environment and invest in the individual to inspire that greatness to emerge. Leadership is about inspiring a group of individuals to achieve extraordinary things. Stephanie is a participative leader in the since that she values the input of team members and peers, but the responsibility of making the final decision rests with her. Participative leadership boosts employee morale because employees make contributions to the decision-making process. It causes them to feel as if their opinions matter. When a company needs to make changes within the organization, the participative leadership style helps employees accept changes easily because they play a role in the process. This style meets challenges when companies need to make a decision in a short period.
  2. Stephanie worked in the Neuro ICU for several years prior to becoming an administrative leader. She worked with a manager that produced the same leadership qualities described in the first question. Stephanie saw how successful the unit was (no CAUTI’s, CLABSI’s, Falls) and how well the staff worked together as a team with this leader in charge. She utilized many of the same tactics and beliefs in her own leadership to mirror what she had previously experienced.
  3. She has earned credibility through the achievement of results that exceed established targets for patient quality and safety. Stephanie has collaborated with staff to reduce the amount of CAUTI’s and CLABSI’s by 50% in the organization. She also set up a quality committee to help spread her expectations of care to other departments in the hospital.
  4. The participative leadership style has really encouraged staff to get involved with patient outcomes. Staff nurses and aides have started participating in the quality committee to add their suggestions and input. This leadership style has also lead to the implementation of a shared governance committee where staff can collaborate with each other on new ideas and suggested improvements to the organization and present it to administration. Staff has become much more involved and seem to hold each other at higher standards with the implementation of the participative leadership style.
  5. Stephanie incorporates evidence based practice into her decision making by referring staff to best practice through research when questions are asked. She also ask them to incorporate what they read in the evidence based research to determine what they could gather to determine if it will fit we into different context. She has also taken this to another level by educating staff on how to gather evidence, interpret evidence, and then apply what they have learned from the evidence. The shared governance groups in turn use this evidence to approach administration about changes in patient care.
  6. Stephanie has done a lot to promote safety and the quality of care for patients. She has implemented a quality committee that reviews CAUTI and CLABSI information as well as look at compliance rates with current protocols and procedures. Stephanie has been an advocate for increased staffing and reduced patient to nurse ratios to improve both quality and safety. At the moment a standard med-surg unit is budgeted to have five patients to one nurse compared a one year ago which was 6 patients to one nurse. In this year, patient falls have dropped by 50% and patient satisfaction scores have been on the rise.
  7. Stephanie has also stepped up and rewarded staff for innovation and creativity. She has given pizza party’s to staff that have brought in ideas that have led to an improved process or protocol. For instance, the cardiovascular recovery team presented evidence based practice that showed a certain type of urinary catheter was shown to reduce the amount of CAUTI’s. The catheter was trialed and is now being used in all units. The unit was rewarded with a party and a plaque to hang in the unit for presenting this useful information.

There is many opportunites for advancement and the development of future leaders. The facility Stephanie works in encourages staff to further their education by offering tuition assistance for degrees that can contribute to the facility. This incentive has encouraged more than 30% of staff to participate in the tuition assistance. The facility also focuses on internal applicants when new positions become open prior to looking outside the facility.

Solution

Nursing

Leadership entails influencing, motivating, and directing others to handle tasks and improve performances in order to accomplish the set goals and objectives. All industries have people who take the leadership roles; however, not all of them are able to handle the assigned tasks. In the field of nursing, there is a need for the caregivers to have a leader that accommodates change to produce the best possible results in the field. Stephanie, an administrator leader in a healthcare organization, embraces the evidence-based leadership practice successfully, and thus sets a good example for other leaders.

Leadership Literature: Evidence-Based Leadership

According to Pfeffer & Sutton (2006), the ideology that decisions are supposed to be based on the best and latest knowledge has influenced the medical field since 15% of the practitioners embrace it. They emphasize that management is learnt through practice and experience, unlike the perception that the leaders should rely on the theoretical knowledge one acquires in schools. The Institute of Medicine (2005) indicates that evidence-based practice is usually embraced during change. The author emphasizes that fundamental changes are required in healthcares in order to improve the quality of care and safety of the patient. Change requires a change of the culture of the workplace, thus, there is a need of a leader that is able to transform the beliefs and practices of the staff members.

Aarons (2006), in his study, concludes that transformational and transactional leadership styles produce a positive attitude towards the adoption of evidence-based practice. While the transactional style entails the shaping of employees perception through the use of reinforcements, transformational leaders inspiration and motivation. Wallen et al. (2010) highlights how leaders can improve the application of evidence-based practice through mentorship. In his findings, people who are mentored to use the practice have a higher readiness to adopt it than those who do not take part in the mentorship. Leaders, therefore, ought to engage all the staff members, in order to increase the chances of embracing the strategy and improving the attitude towards its use.

Analysis of the Interview

Leaders embrace different styles of leading, such as democratic, laisserz faire, and authoritative. Stephanie’s leadership style is participative. She engages the workers in making decisions; however, she makes the final decision. Although leaders may have the same leadership style, it is not necessarily true that they may hold the same principles. Personal leadership principles emphasize on what motivates the leader, the specific goal one targets, and how to treat the followers. From the interview, Stephanie recognizes that greatness resides in all people. Thus, she creates an environment for inspires the greatness to emerge, while inspiring the individuals to attain extraordinary goals. Personal philosophies may arise from experiences, influence from others, past failures and achievements, and the ideologies one holds. For Stephanie, her philosophy adopted when she was working in the Neuro ICU. She was under the leadership who embraced the philosophy and produced excellent results.

The leadership style and philosophy one embraces influences organizational behavior. According to Wamy & Swarmy (2014), participative leadership helps improve the input level of the firm and the innovative level. In Stephanie’s case, she has been earning credibility through the attainment of results that exceeds the established target for the quality and safety of the patients. More specifically, she has managed to reduce the CAUTI’s and CLABSI’s level by 50%. By embracing her philosophy, she has set up a quality committee that target at the development of her followers. The influence has not only been on the organization but also on the staff members. For example, the staff has been getting involved with the patient outcome. The employees participate in the quality committee through making feasible suggestions. They work together to develop new and innovative ideas that boost the performance level.

Leaders ought to embrace the fact that they have not mastered everything in their area of expertise. Through evidence-based practice, they incorporate the best evidence from their research into their area of expertise (The Sentinel Watch, 2016). Stephanie is not an exception. She embraces the concept through researching and integrating the best results into her decisions when questions arise from her staff. She has also been directing the members to incorporate the practice. For instance, she asks them to determine whether what they read fits into a specific context. She also takes time to educate the employees on how one gathers information, interprets, and applies it. The practice has enabled the shared governance groups to approach the administration on changes pertaining patient care.

Besides bringing a change into an organization, leaders seek for ways of ensuring its maintenance (Czichos, 2014). One of the major changes Stephanie has made in the health care is promoting a culture of patient safety and quality of care through the formation of the quality committee. The team reviews the CAUTI and CLABSI and the compliance to the set protocols and procedures. Moreover, she advocates for a reduced patient to nurse ratio through increased staffing. The current ratio is 1:5, which has dropped from last year’s 1:6. As a result, there is increased patient satisfaction. To maintain the change and improve the level of creativity and innovation, the administrator rewards the staff members. For example, she gives pizza parties to people who issue ideas that help improve on change. Some of the people that received the reward were the members of the cardiovascular recovery team that helped lower the CAUTI.

According to deGrandpre (2010), mentoring and leadership succession eliminates the risk of having non-performing employees or inadequate expertise in handling the leadership tasks when the leader leaves the corporation. Stephanie participates in the development of future leaders through encouraging the staff members to further their studies. She has developed a program whereby people who pursue degree that can help improve the operations of the organization get tuition assistance. The program has supported more than 30% of the employees. This has raised the ability of the healthcare to recruit internal applicants for various vacant positions. She also focuses on succession through preparing her deputy administrator to handle the tasks associated to her position. In her absentia, the deputy runs the administrative operations efficiently and effectively.

Comparison of Literature to the Interview

Evidently, Stephanie embraces the evidence-based practice since she researches and incorporates the best knowledge when making decisions. She falls under the 15% of the practitioners, whom Pfeffer & Suffon (2006) estimate to have adopted the strategy. He is aware that management is mainly learnt through experience and practice. She adopted her leadership philosophy and some of her practices from her working in the Neuro ICU sector. Unlike Pfeffer & Suffon (2006) who claim that the knowledge at school is outdated, she has an appreciation for schooling. This is shown by the tuition-support program she started for helping the staff members that would like to further their education.

Similar to the Institute of Medicine (2005), Stephanie embraces the thought that change is best facilitated by the evidence-based strategy. The changes that she brought to the hospital were based on research. Although she classified her leadership as participative, the Aarons (2006) study suggests that she also embraces transformational leadership. This is because she motivates and inspires the employees to change the practices within the institution to increase the level of effectiveness and efficiency. As a result, the workers have increased their participation in the quality committee, thus promoting a culture that supports change.

Stephanie has embraced the concept of mentorship, which facilitates the positive attitude towards the evidence-based practice. She mentors the staff through teaching them how to apply the strategy. Mentoring her deputy and preparing him for succession increases the chances of the operation continuing even after her departure from the workplace. This is because Wallen et al (2010) indicates that people who undergo the mentorship program have a higher chance of applying the practice.

Conclusion

Stephanie is among the few leaders who have been able to embrace the evidence-based leadership practice successfully. She has been influencing her staff to also adopt the strategy in making decisions. As a result, the organizational performance has been on the rise. The organizational culture has also changed to adopt the practice due to her transformational leadership, where she awards the people who come up with the most feasible ideas that help solve some of the problems in the institution. Clearly, Stephanie is an exemplary example for other leaders due to her success in integrating evidence-based practice in the healthcare organization.

References

Aarons, S. (2006). Transformational and transactional leadership: association with attitudes towards evidence-based practice. Psychiatr Serv, 57(8), 1162-1169.

Czichos, R. (2014). Change Management. Freiburg im Breisgau, Germany: Haufe-Lexware.

DeGrandpré́, S. (2010). Common-sense workplace mentoring: A do-it-yourself system for strengthening your business– one person at a time. New York: iUniverse, Inc.

Institute of Medicine (U.S.). (2005). Keeping patients safe: Transforming the work environment of nurses. Washington, D.C: National Academies Press.

Pfeffer, J., & Sutton, R. (2006). Evidence-based management. Retrieved from https://hbr.org/2006/01/evidence-based-management

The Sentinel Watch. (2016). Strong nursing leadership is essential to evidence-based practice. Retrieved from http://www.americansentinel.edu/blog/2016/07/19/strong-nursing-leadership-is-essential-to-evidence-based-practice/

Wallen, G. et al. (2010). Implementing evidence-based practice: effectiveness of a structures multifaceted mentorship programme. J Adv Nurs, 66(12), 2761-2771.

Warmy, N., & Swarmy, D. (2014). Leadership styles. Advances in Management, 7(2), 57-64.

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