The importance of healthcare management is being understood on the medicine front with various players and places. It works with a variety of health professionals. Medical experts do advanced researches and healthcare management is devoted to making the best use of the services of these people and places (Ronald Jefferson,2008, para 1).
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Nancy M. Lorenzi et al. (2004) describe that leadership plays a significant role in all organizations but its importance has been understood more in the area of health informatics since it is complex; it has interdisciplinary nature; it is dependant on constant changing technology and it has the participation of users. This chaotic environment needs a leader who is actually extraordinary: an excellent communicator, knowledgeable in both the fields as technology and clinical domains; innovative and adaptable and be tactful to convince many different smart people from different backgrounds so they can achieve goals. Leaders have to be extra brilliant in informatics otherwise if they are bad leaders and fail in projects, stakeholders and users of informatics become hesitant in giving them the next projects.
Nancy M. Lorenzi et al. (2004) further say that researchers believe that leadership is the combination of traits and skills and has a clear vision. It consists of the ability to encourage people to carry out that vision. These supposed trait theories of leadership have surrendered to contingency and situation theories to take the leaders, the followers and the context into consideration. There is not any skill of that type that can be applied any time on any organization. According to Goleman emotional intelligence is the ability which manage one’s relationship with others and this ability is required by a good leader. He has made four categories of these abilities: self-awareness, self-management, social awareness and social skills.
- Trait Theory: According to McGregor, “Researches say that it is more successful to think leadership as a relationship between leader and the situation than to think it as a universal pattern of characteristics acquired by specific people.” (Linda Roussel et al, 2005). This statement entails that leadership is dependent upon human relations roles and needs different characteristics due to different situations. Some traits are very common in all good leaders like integrity, trustworthiness, honesty, goal-oriented, experienced communicator, hardworking, dedicated and commitment (Linda Roussel et al, 2005). Gardener’s writing has related leadership with two traits: The Tasks of Leadership and Leader Constituent Interaction. According to Gardener, a leader performs nine tasks as affirming values, envisioning goals, motivating, achieving workable unity, managing, serving as a symbol, explaining, renewing, representing the group. In Leader Constituent Interaction Gardener talks about Charisma as a quality that makes one person different from others: superhuman, supernatural, gifted with exceptional qualities or power. This leadership can be good or bad (Linda Roussel et al, 2005).
- Behavioral Theories: Douglas McGregor’s X and Y theory narrates that each person is an individual and interacts with other individuals. Then this individual reflects the behavior of other individuals. This individual is affected by the emotions and attitudes of others. The constituent becomes dependant on the leader and needs fair treatment. Both the constituent and the leader wish for a successful relationship that materializes through the actions of the leader (Linda Roussel et al, 2005). A knowledgeable person proves to be an effective leader. Leaders try to maintain the standards and also make efforts that their constituents meet those standards. A secure and independent atmosphere makes constituents responsible. Leaders also need security before they give any responsibility to the constituents (Linda Roussel et al, 2005).
Fiedler’s Contingency Model of Leadership Effectiveness says that an organization is responsible for a leader’s success and failure so the leaders can be trained to handle the situation and to learn which situation is better for them and which is not. His theory states that a leadership style can be effective or ineffective based on the situation. (Linda Roussel et al, 2005).
Linda Roussel et al (2005) believe that transforming leaders are concerned with the people’s basic needs, hopes, wants and expectations. They are innovative. Leaders should make their constituents independent and should develop their strengths in them.
Linda Roussel et al (2005) state that the healthcare system is going through a major change. These organizations are being redesigned and restructured to face the challenges of these changes and to meet the requirements of patient care. Additionally, People in rural areas and inner cities have a shortage of hospitals and healthcare personnel. Leaders should discover ways to motivate their staff to make balance in this chaotic kind of situation. They should be flexible and should understand the uncertainty. They should understand the needs and values of constituents.
Bennis and Nanus define a transformational leader as the one, ‘who makes people work; who transforms followers into leaders and who may translate these leaders into agents of change.’ They believe that the center of leadership is power and which has the energy to instigate and continue action transforming intention into reality’ These leaders do not make use of power to control constituents, instead, they strengthen constituents to visualize the organization and trust the leaders to achieve goals which are advantageous for them as well as for the organization (Linda Roussel et al, 2005).
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Linda Roussel et al (2005) argue that leadership cannot be considered the exercise of power instead it is the empowerment of others. Here the goal of the leader and the constituent become one, having a combined purpose. Transformational leaders will organize their staff by concentrating on the wellbeing of the individual and cultivating the modern work environment. Experts appreciate that leadership signifies cooperation instead of competition. People are encouraged when they participate in decision making and they are praised for quality and excellence rather than punishment. In nursing, empowerment outcomes with improved patient care, fewer staff sick days and less destruction. Nurses who become transformational leaders possess a satisfactory staff that is happy with their job and serves the organization for a longer period.
Bennis has discovered four skills for effective transformational leadership (Linda Roussel et al, 2005):
- Management of attention- it is achieved by keeping vision and sense of goals. This vision defines in which direction the health organization should go and how should it serve society.
- Management of meaning- Nursing leaders make changes in the social architecture and culture of health care organizations and for that, they use group discussion, agreements and consensus-building. They favor skills like creativity and innovation in an individual. Barker believes that nurse transformational leaders will take care of vision, goals, objectives, rewards, support and appraisal. The important thing is all these elements will appeal to these leaders.
- Management of trust- it is related to reliability. Nurses give value to those leaders who believe in fair decisions and whose judgment is sound and consistent.
- Management of self- it tells about knowing one’s skills and using them effectively. If the leaders are not effective they can discourage a nursing unit which can lead to poor patient care. When stress is reduced, nurse leaders need to master the skills of leadership (Linda Roussel et al, 2005).
Chiapello (1998) mentions when there are strong competitive values of different worlds, there is an approach to leadership of co-leaders, like the administrative and clinical leaders of a health care organization, who actually signify individual worlds and can connect personally with the domestic world (Ewan Ferlie et al, 2005).
Linda Roussel et al (2005) discuss that successful leaders trust in the concept of decision making and even if their decisions are not much admired they do not stop taking responsibility for decision making. Constituents also become willing to participate in the decision-making process but they want the direction of their leader. It generally happens in a time of crisis.
All the above-discussed theories look for the effective skills in a healthcare leader which should actually impact his constituents. A leader is supposed to be patient, caring and tactful to handle the situation according to the needs of the healthcare management as well as the patients and this should really be done by taking care of his constituent’s benefits also.
A leader may face difficulties in achieving his target of making everyone satisfied but this proves his impression and his efficiency to handle everyone successfully. His innovative ideas can make powerful not only the whole organization but also the constituents working with him.
Linda Roussel et al (2005) finally review that transformational leaders have flexibility and adaptability according to leadership styles to face the changes happening in this healthcare environment. Gender issues related to leadership in health care organizations have not been studied well. Gender differences in leadership style do not transform one style to other. Nurses may accept leaders who have unique leadership quality and this environment will be favorable for both men and women nurses to grow self-confidence and become strong leaders.
Ferlie, Ewan et al. (2005), The Oxford handbook of public management (p.457), New York, Oxford University Press.
Jefferson, Roland (2008), Health Care Management Employs Effective Leaders, Article base free online directory.
Lorenzi, Nancy M et al. (2004), ‘Leadership’, Transforming health care through information, Edition: 2 (p.188-189).
Roussel, Linda et al. (2005), ‘Leadership and Evidence-based Management’, Management and leadership for nurse administrators, Edition: 4 (p.165-174), Sudbury, Jones and Bartlett Publishers.