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Leading Change in Health Care Practice Essay

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Updated: May 14th, 2019

Introduction

In the recent past, nursing profession has become a widespread career choice as more high school and college graduates are looking forward to embracing the profession. However, only effective management/leadership roles can help to achieve success in the nursing profession, since these roles play a critical role in shaping the goals of the health care organizations.

More over, leadership helps to define the overall culture of the health care organizations, and it motivates the behavior of the nurses towards accomplishment of goals.

Since the goals of a clinical staff must be patient centered, the managers are tasked with the role of ensuring that the implementation of the relevant leadership style is effected. This can be achieved by identifying a change initiative, and then coming up with viable ways that influence all team members in the medical circle to provide proficient services.

Critical Analysis Of The Role Of Leaders As Agents Of Organizational Change

Analysis of Change Initiative and Intended Outcomes

The practice of nursing is compounded with a number of challenges, with needle stick safety practices emerging as one of the leading challenges. According to Centre for disease control and prevention (2009), there is a positive correlation between the use of sharp needles and diverse risks at various stages of their use.

The high levels of risks are attributed to the following factors, among others: physical appearance of the needles, the methods of disposal used by the medical practitioners, the level of education of the medical practitioners, and the working condition for the medical practitioners.

One thing that is of importance to note is that needle stick injuries pose a major threat to the health care workers, since they do not only expose them to blood borne diseases, such as the hepatitis B and C, but also to HIV/AIDS. Therefore, this calls for a change initiative within the health care institutions.

There are a number of initiatives that have already been employed to improve the safety practices in a clinical setting. One of the initiates includes eradicating unsafe medical practices through providing education to medical practitioners.

Despite the fact that many healthcare institutions have already provided education for handling sharp needles, the efficacy of this education has not yet been practical enough due to divergence of attitude amongst the health care workers (Van Knippenberg & Schippers, 2007), making the healthcare compliance program a challenge.

This provides us with the information that unsafe practices in a health care institution may also result from workers’ attitudes towards implementation of safety standards.

Therefore, management and leadership roles serve as key factors in making sure that the medical practitioners refrain from non-compliance of the safe work practices (Hannah et al., 2008). Therefore, have the ultimate responsibility of ensuring that the healthcare workers acquire a positive attitude.

The fact that needle stick injuries continue to happen despite the medical practitioners having attended accident prevention courses highlights that nurses, more often than not, do not adhere to the knowledge of the practice acquired from training sessions. With this in mind, training sessions for the medical practitioners should be incorporated with an additional inspiration.

Therefore, an appropriate initiative should commence with creating safety awareness for the medical practitioners, utilizing the new devices present in the healthcare setting, and, finally, creating a positive attitude towards the innovation process (Jones, 2008).

The change process would improve work practices by creating awareness, improving the attitudes of health practitioners, and offering education on how to handle the sharp needle sticks in a manner that facilitates eradication of infection amongst the health workers.

With this initiative in place, the work practices will improve significantly because this initiative will minimise the risks of patients and the nurse partitioners during the therapy injections, as well as getting injuries from the disposal units. The management team will therefore set an indicator that will be used to assess whether the goal of reducing the rate of needle stick injuries has been achieved.

The indicator will be to reduce the number of needle stick injuries for the healthcare workers to 0.5% annually. This is based on the fact that if an effective intervention would be put in place, then accidents resulting from needle stick could be reduced significantly(Stone & Gershon, 2006).

Analysis of Leadership Contribution in the Change Phase

Jasper & Jumaa (2005) affirms that using the Lewin’s change model is imperative while developing an appropriate improvement plan since it upholds the process of change by following a clear sequence of phases, which include

  1. Unfreezing phase: this phase necessitates the need for change by providing substantial evidence for change, and how the innovation should be handled.
  2. Change phase: the management should clearly define the intended changes, as well as ways of achieving the highlighted changes.
  3. Refreezing: in this phase, the management should focus on the awareness of the new changes, as well as the challenges that may hinder the implementation of the changes. These challenges should form the basis for analysing improvements.

While defining the intended changes, it is also vital for the management to consider the policies, review the procedures, and then implement the best practice methods. In doing so, the managers will have a clear responsibility of carrying out various duties that will help to protect the medical practitioners from needle stick injuries. These duties include the following, among others:

  1. Helping the nurses in making a selection and evaluating the devices that have safety features;
  2. Implementing the use of devices that have safety features;
  3. Helping to carry out safe disposal practices;
  4. Informing the nurses about the hazards related to the needles, which have already been observed by the management; and
  5. Making a good reporting system of the needle stick related incidents in order to ensure that the incidents are well analysed (Vroom & Jumaa, 2005).

Analysis of Group Processes and the Implications of Change

The change implementation phase can only be successful if a high degree of collaboration between the managers and all the employees is put in place. With this collaboration, the managers should be in a position to offer assistance through a training program. This innovation should be efficient in terms of time management, cost, and should have the capacity of providing quality care for the patients (Kaiser et al., 2008).

However, it is of importance to note that every innovation is associated with barriers (Kotter, 2007). And in this regard, teamwork is hard to instill to employees who do not find learning beneficial to them and who do not share the same vision. This stems from the fact that people are naturally resistant to organizational changes. Thus, learning may be hard for people who have closed mindsets.

The fact that teamwork does not recognize individual efforts makes it hard to adopt a teamwork culture (Jehn, 1997). Therefore, the management should encourage a learning system that would not only be beneficial to the healthcare setting as a whole but also to each individual. In addition, since innovation is characterized by adopting a new organizational culture, a number of organizational conflicts are bound to occur.

From this point of view, the management holds the overall responsibility of taking into account differences that exist among the medical practitioners with regard to values and working patterns.

Thus, the management should concentrate on a number of factors, including the amount of support that should be provided to medical practitioners from diverse cultures, the amount of support needed while building a cohesive relationship with workers from diverse cultures, and the expectation of medical practitioners from diverse cultures (Kerr & Tindale, 2004).

In turn, this provides the management with a comprehensive knowledge that helps to provide a clear way of innovation, hence helping to create grounds for solutions to challenges that emanate from change.

In assessing the amount of support that should be provided to medical practitioners from diverse cultures, the leader should note that modern learning organizations should exhibit five characteristic: personal mastery, systems thinking, shared vision, mental models, and team learning (Yukl, 2009).

Covey (2006) alleges that many managerial problems encountered in organizations result from leaders who fail to see organizations as a dynamic process encompassed with diversity; hence, they fail to see the cause and effect as the best practices while implementing changes. More so, system thinking helps every managerial team to highlight the lagging indicators of the innovation.

Team learning is crucial in a change process, as it helps to build a team with a common goal. Team learning builds up the shared vision and personal mastery (Kaplan, 2007).

Thus, this health care organization should not only set objectives together but also learn together on how to walk around with the sharp instruments, how to dispose of the sharp objects, and how the needles are removed from the syringes, among other ways of achieving intended changes.

Contribution of Change Implementation to Outcomes

The level of success emanating from the change process is facilitated by the mutual commitment, as it encourages formation of a self-management team that upholds high-level cooperation. The learning experience gained by medical practitioners at all levels makes them appreciate the benefits of the changes, thus putting the organization in a better position of benefiting from the transformation.

This kind of atmosphere is important in preventing individual and group resistance to the proposed changes (Burke et al., 2007). The reason for resistance, such as threat of status, is effectively eliminated since no one is required to drive the transformation process by him/herself.

Training serves a crucial role to workers who require new skills to cope with the changes. The change implementation phase contributed to the outcome of the change process through goal setting, effective communication, and motivation.

In goal setting, the change system helped employees to understand the link between their responsibilities and the overall objectives of the organization. The habit of goal setting is done by both the managers and employees. This resulted to greater efficiency and provided a good tool for analysis (Rigolosi, 2005).

In the Communication sphere, the system adopted by the company encouraged charismatic communication between managers and employees. Communicating about work performance created a sense of security for the employees, and helped the healthcare setting in retention efforts. It provided ample time for all employees to learn and grow together, and thus fostered a good organizational culture (Waldman et al., 2004).

Motivation, on the other hand, used the appraisal system as a tool of motivation, as employee rewards were tied directly to achieving performance with minimal needle stick injuries. This enhanced productivity and efficiency as the employees received knowledge on how their presence and contribution is valued, and hence made them feel more committed to the job and the organization as a whole (Avolio,2009).

Self-Analysis Leadership Development and Key Principles of Management Practice

Given that needle stick injuries continue to happen despite medical practitioners attending accident prevention courses, it is of importance for the health care institution to identify the key principles for leadership/management practice. Since accidents emanate from lack of adhering to the knowledge of the practice acquired from training sessions, it necessary to adapt a new leadership strategy.

Successful innovation, however, should be characterised by knowledge acquired from the training sessions, such as knowledge on safe ways of handling the sharp objects and the appropriate guidelines to follow in case a needle stick injury happens. In order to achieve a successful implementation of the initiative, a high participation of the healthcare workers should be put in place.

The role of the leader is not only to provide alternative needle sticks and education but also to provide a transition plan that eradicates tension between workers, anxiety emanating from unclear goals, as well as organizational conflicts. Therefore, the key principle for leadership/management practice is to eradicate needle stick injuries through an integration of opinions from every worker.

This can be achieved by identifying diverse ways that stimulate achievement of goals among the group members and making a point of being acquainted with employees’ opinions to a point where the dynamic process of transition is recognized (Hackman & Wageman, 2007).

As a result, the healthcare institution is able to understand all areas of the group, including networks, boundaries, and the relationships that exist between diverse responsibilities (Kerr & Tindale, 2004).

Critical Analysis Of Strategic And Operational Process That Affect Leadership And Management Within An Organization

Differences and Similarities between Leadership & Management

While implementing innovation, it is of importance to note that clinical officers are mostly characterized by fear of lack of enough resources, as well as work overlap (Kotter, 2007). In this case, effective transition needs to be put in place since the rate at which change is achieved determines the rate of success for the change (George, 2007). In this case, leadership entailed influencing workers to adapt to the innovation.

This was achieved by communication the transition plan through good interpersonal skills, which took into account that an effective leader must be in a position to analyse his personal opinions and incorporate both management and leadership styles, since they both serve to change the attitude of the employees.

In the leadership sphere, the leaders should demonstrate both legitimate and reward powers. Legitimate power, in this case, should be demonstrated by putting in place a program that must be adhered to by every employee (Jasper & Jumaa, 2005). For instance, the leader should affirm that it is mandatory for every medical practitioner to work for 48 hours a week.

Reward power, on the other hand, should be demonstrated by offering rewards such as more benefits and increased pay for employees who show competence (Jasper & Jumaa, 2005). For instance, the leader should affirm that the medical practitioner who demonstrates proficiency in the use of new needles should receive yearly bonus, and thereby change the employees’ attitude towards innovation.

The management role, on the other hand, should try to identify the resources that would effectively address and promote adoption of the innovation. More over, the management should use a checklist to verify whether there is an elimination of errors in this health care setting (Patronis Jones, 2007).

This checklist is of importance since it would help to carry out a cross comparison between the old and the new process of care, and thereby provide the workers with comprehensive information relative to the risks associated with the old practices and the benefits associated with the new practices, which are obtained from the cost-benefit analysis.

In turn, this facilitates successful transition because the workers are able to relate their efforts with the already set goals.

References

Avolio, B., Walumbwa, F., & Weber, T. (2009). Leadership: Current Theories, Research, and Future Directions. Annual Review of Psychology, 60, 421-449.

Burke, C. S., Sims, D. E., Lazzara, E. H., & Salas, E. (2007). Trust in leadership: A multi-level review and integration. Leadership Quarterly, 18 (6), 606-632.

Centre for Disease Control and Prevention. (2009). Exposure to Blood. Workbook for Designing, Implementing and Evaluating A Sharps Injury Prevention Program. Retrieved from

Covey, S.M. (2006). The speed of trust: The one thing that changes everything. New York: Simon & Schuster.

George, B., Sims, P., McLean, A. N., & Mayer, D. (2007). Discovering your authentic leadership. Harvard Business Review, 85(2), 129-138.

Hackman, J. R., & Wageman, R. (2007). Asking the right questions about leadership: Discussion and conclusions. American Psychologist, 62(1), 43-47.

Hannah, S. T., Avolio, B. J., Luthans, F., & Harms, P. D. (2008). Leadership efficacy: Review and future directions. Leadership Quarterly, 19(6), 669-692.

Jasper, M. & Jumaa, M. (2005). Effective Healthcare Leadership. Oxford: Blackwell Publishing.

Jehn, K. A. (1997). A qualitative analysis of conflict types and dimensions in organizational groups. Administrative Science Quarterly, 42(3), 530-557.

Jones, G. (2008). How the best of the best get better and better. Harvard Business Review, 86(6), 123-127, 142.

Kaiser, R. B., Hogan, R., & Craig, S. B. (2008). Leadership and the Fate of Organizations. American Psychologist, 63(2), 96-110.

Kaplan, R. S. (2007). What to ask the person in the mirror. Harvard Business Review, 85(1), 86-95.

Kerr, N. L., & Tindale, R. S. (2004). Group performance and decision-making. Annual Review of Psychology, 55, 623-655.

Kotter, J. P. (2007). Leading change: Why transformation efforts fail. Harvard Business Review, 85(1), 96-103.

Patronis Jones, R. (2007). Nursing Leadership and Management: Theories, Processes and Practice. Philadelphia: F.A. Davis Company.

Rigolosi, E. (2005). Theories of Management and Leadership. New York, N.Y: Springer Publishing Company.

Stone, P., & Gershon, R. (2006). Nurse Work Environments and Occupational Safety in Intensive Care Units. Policy, Politics, & Nursing Practice, 7, 4, 240-247.

Van Knippenberg, D., & Schippers, M. C. (2007). Work group diversity. Annual Review of Psychology (Vol. 58, pp. 515-541).

Vroom, V. H., & Jaago, A. G. (2007). The role of the situation in leadership. American Psychologist, 62(1), 17-24.

Waldman, D. A., Javidan, M., & Varella, P. (2004). Charismatic leadership at the strategic level: A new application of upper echelons theory. Leadership Quarterly, 15(3), 355-380.

Yukl, G. (2009). Leading organizational learning: Reflections on theory and research. Leadership Quarterly, 20(1), 49-53.

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