Leadership in Nursing Healthcare

Introduction

Healthcare leadership is a complex multifaceted process, comprising of diverse definitions and qualities. It is highly beneficial for healthcare nurses to be able to identify the leadership styles applicable to their nursing practice. Being proficient in identifying these styles qualifies nurses to advance their expertise to become better leaders and also improves the relationship with other leaders and colleagues. Effective leadership is essential for the safety of the patients and better patient outcomes. This essay explores the connection between leadership and patient safety, different leadership styles and their main features and explains how these leadership styles are applicable in different clinical instances.

Leadership and patient safety

Literature addressed the significant impacts of nursing leadership has on patient safety is extensive and a strong connection exists between patient safety and leadership in health care systems (Wong et al., 2013). Patient safety can be defined as the inhibition of mistakes and adversative effects to the patients allied with the healthcare system. With the advancement of the healthcare system, maintaining patient safety is also becoming more challenging. The main properties of safety emerge from the accurate interactions between components of the healthcare structure, thereby leading the approach to a well-defined emphasis for patient safety, namely system. The objective of patient safety can also be stated as the prevention, evasion, and amelioration of adverse outcomes or harms stemming from the course of care. Thus effective leadership is essential for the patient-centred care and patient safety.

The essence of nursing leadership is to motivate, to inspire, to promote ethics, to generate and empower a consistency emphasis on the essentials of the patient being served. By the means of effective leadership, strategies can be implemented to prevent errors, make coordination with the patient and their families, delivery of individualized care to maintain diverse cultural health beliefs of the patients and most importantly maintain patient safety. An emerging body of information now demonstrates a strong association between leadership activities and safety metrics (Wong et al., 2013). A study found that high-performing healthcare organizations with high rank on measures of safety and quality tend to have clinical leaders with more skills in safety and quality issues and devoted more time to discussion of safety and quality with the management bodies. Studies have provided more insight into how leaders can positively influence safety and found that leaders of high-quality hospitals used more effective leadership practices to monitor and improve safety. These practices embrace planned use of data to improve care by allocating detailed eminence objective and frequently observing performance dashboards etc. (Scott & Miles, 2013). Clinical leaderships can address exact safety issues and noticeably illustrate the significance of patient safety as an organizational priority.

Leadership styles

Appropriate leadership styles are crucial for instigating evidence-based interdisciplinary clinical practice. The commonly used leadership styles are autocratic, democratic, transactional, transformational, situational, visionary and Laissez-Faire leadership (Huber, 2013). The manner in which clinical leaders execute leadership over their staff has positive or negative consequences that can give rise to far-reaching effects on the manoeuvres of healthcare organizations (Scott & Miles, 2013). A clinical professional’s individual style of leadership definitely holds a substantial impact on not only patient safety but also on vital health care aspects like employee attrition, teamwork and communication, morale, turnover rate, feedbacks and productivity (Wong et al., 2013).

According to Huda (2014), autocratic leadership style characteristically involves leaders or nurse managers who make all relevant decisions, provides working orders and guidelines and also gives instructions to subordinate staffs who must follow under attentive supervision. In this styles, leaders do not consult other staff and the leaders retain as much power and decision-making authority as conceivable. Staffs are expected to follow instructions without receiving any explanation.

The democratic style of leadership enables greater participation from subordinate workers in the decision-making process of the organization. Despite the fact that the democratic leaders have the ultimate decision-making authority, they gather ideas, information, and feedback from employees before concluding the very decision that will affect those employees (Huber, 2013). This is an extremely effective method of leadership since workers are more likely to present exceptional efforts when they feel valued. Employees feel appreciated when their contribution becomes an integral portion of the decision-making process of an organization. Democratic leadership prospers in healthcare context because of the diverse skill sets and educational backgrounds of staff members. This style encourages open communication of clinicians and decision making (McKeown & Carey, 2015).

According to Huber (2013), in transformational leadership style, a leader works with followers to detect the desirable changes, fashioning a revelation to direct the modification through encouragement and implementing the transformations in tandem with dedicated associates of the group. This style is most effective when handling lower-skilled employees who need closer observation or at the time of crisis (Clarke, 2013). Transformational leaders assists in motivating, increasing confidence and work performance of staff by means of multiple appliances such as linking the employee's sense of self to the identity of the institute, being a role model for subordinates, inspiring employees to take bigger possession for their work and understanding the strengths and flaws of employees; it allows the leader to align employees with responsibilities that enrich their performance. (Antonakis & House, 2014).

Clinical instances

The assortment of a leadership style is entirely reliant on the clinical circumstances and the requirements of the patients. The application of autocratic or authoritarian leadership can be effective for a nurse in charge of the ward working with an inexperienced junior team. A patient unexpectedly collapses on his bed who shows no responses and the leading nurse suspects that he is having a cardiac arrest. The leading nurse can direct the followers and allocate tasks by applying autocratic leadership for the patient’s safety (McSherry & Warr, 2011). The leader cannot be democratic or transactional in this situation because the team members are inexperienced and expecting effective interventions from them can lead to the loss of valuable time for treatment of the patient.

When prescribing medicines clinical leaders frequently applies democratic leadership to avoid any medication error. It is always better to consult with the experienced team members and not to be an autocratic leader before prescribing a drug (Cunningham et al., 2012).

Transformational Leadership has a significant indirect effect on patient falls. Inspiring employees to rigorously assess the safety measurements of the organization, evaluate existing organizational attention to fall, improve supports for fall prevention programs and detect available as well as required resources for fall management can be done effectively by transformational leadership (Higgins, 2015). Autocratic and democratic leadership cannot effectively motivate the followers for patient safety and reduction of fall incidents.

Conclusion

Different leadership styles are suitable according to the ever-changing environment of the healthcare system. Several pieces of evidence demonstrated a noteworthy association between affirmative leadership styles, behavior and practice with amplified patient satisfaction and declined adverse incidents. Autocratic leadership is highly effective in an emergency situation. Hospital administration, from workforces and secretarial divisions to amenities upkeep and insurance billing necessitates autocratic leadership to ensure accountability and uniformity. Simultaneously, physicians work collaboratively under democratic leaders to avoid medication and treatment errors. On the other hand, many results proposed that an emphasis on developing transformational nursing leadership can be an imperative organizational approach to enhance patient safety.

References

Antonakis, J., & House, R. J. (2014). Instrumental leadership: Measurement and extension of transformational–transactional leadership theory. The Leadership Quarterly, 25(4), 746-771.

Clarke, S. (2013). Safety leadership: A meta-analytic review of transformational and transactional leadership styles as antecedents of safety behaviours. Journal of Occupational and Organizational Psychology, 86(1), 22-49.

Cunningham, F. C., Ranmuthugala, G., Plumb, J., Georgiou, A., Westbrook, J. I., & Braithwaite, J. (2012). Health professional networks as a vector for improving healthcare quality and safety: a systematic review. BMJ quality & safety, 21(3), 239-249.

Higgins, E. A. (2015). The Influence of Nurse Manager Transformational Leadership on Nurse and Patient Outcomes: Mediating Effects of Supportive Practice Environments, Organizational Citizenship Behaviours, Patient Safety Culture and Nurse Job Satisfaction.

Huber, D. (2013). Leadership and nursing care management. Elsevier Health Sciences.

Huda, S. (2014). Autocratic Leadership In Nursing. i-Manager's Journal on Nursing, 4(3), 25.

McKeown, M., & Carey, L. (2015). Editorial: Democratic leadership: a charming solution for nursing's legitimacy crisis. Journal of clinical nursing, 24(3-4), 315-317.

McSherry, R., & Warr, J. (2011). Implementing Excellence In Your Health Care Organization: Managing, Leading And Collaborating: managing, leading and collaborating. McGraw-Hill Education (UK).

Scott, E. S., & Miles, J. (2013). Advancing leadership capacity in nursing. Nursing administration quarterly, 37(1), 77-82.

Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of nursing management, 21(5), 709-724.