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Leader-Exchange and Social Network Theory in the Healthcare Setting


Leadership in the healthcare setting is vital as it contributes to the development of efficient strategies and methods to provide high-quality services. It has been acknowledged that the development of the relationship between the leader and the group members affects the overall efficiency of the organization (Blake, Mouton, Barnes & Greiner, 1964). Various theories on the matter exist, and all of them can be applied in this or that setting. The Social Network Theory and Leader-Member Exchange theory are two paradigms that can be employed in numerous public health scenarios.

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Comparison of the Two Theories

The two theories concentrate on the relationship within the organization with a focus on the links between the leader and the followers. Dine, Kahn, Abella, Asch and Shea (2011) note that leaders in the clinical setting value communication, personal attributes among other aspects. The Leader-Member Exchange can help such leaders to develop proper relationships and communication patterns (Wilson, Sin & Conlon, 2010). According to the theory, the leader the leader assesses team members’ characteristics and places them in in-group (employees receive a lot of attention) and out-group (employees get little attention) (Nahavandi, 2014). This leads to increased motivation in people within the in-group and reluctance to work harder in the out-group employees. The weakness of the theory is its focus on the leader and absolute negligence of workers’ attitudes (Sin, Nahrgang, & Morgeson, 2009).

Likewise, the Social Network Theory includes analysis of the relationship between the leader and the team members. This is referred to as the ego-centric network as all people are linked to one person (Mobley, Li & Wang, 2012). It is noteworthy that the two theories have rather different focuses as the leader-member exchange concentrates on the relationship between the leader and team members while the social network theory is more holistic and involves more attention to the relationship within the team. Clearly, it will be effective to employ a mix of these approaches to develop an efficient leadership strategy.

Unified Leadership Theory

Salmela, Eriksson and Fagerström (2011) claim that an active leadership paradigm should include three main components: leading relationships, leading cultures and leading processes. It is possible to extend the boundaries of this approach by dividing the culture into some aspects. Thus, setting particular organizational values should be a leader’s priority as the leader has to address the diversity of his/her team and create a favorable environment (Graber & Kilpatrick, 2008). Ethical leadership is another important aspect of culture, and leaders should make sure that all their decisions are ethical (Holmes, 2010). Notably, ethical decision-making and corporate responsibility positively affect the development of links within teams and organizations (Tuan, 2012).

The domain of relationships can be also divided into such aspects. One of them is choosing the right leadership style as it has a significant impact on the performance, and it also defines the development of the relationship (Franco & Almeida, 2011). It is necessary to add that transformational leadership is often the most applicable method in many settings (Borkowski, Deckard, Weber, Padron & Luongo, 2011). The social network theory provides valuable insights as it is clear that the relationships among team members will be based on different ties. The leader should take into account these links when developing teams and guiding team members (Hakansson & Akerman, 2011). The attention to these aspects will allow the manager to include all the employees in the in-group and, hence, to increase their motivation and performance. It will also enable the leader to develop proper links within the group.

Public Health Scenario

It is possible to assess the efficiency of the new paradigm through analysis of a public health scenario. Thus, a group of healthcare professionals is assigned to develop an improved reporting system. Team members are representatives of different departments. It is noteworthy that the group is diverse in terms of race, gender, age, and cultural background. The team members barely know each other and, hence, the leader has quite a complicated task to complete.

Application of the new paradigm will make the process easier. Thus, analysis of traits enables the manager to develop an appropriate behavioral model (Derue, Nahrgang, Wellman & Humphrey, 2011). At that, the manager should focus on strengths of each employee to be able to place him/her into the in-group. This will be beneficial for the employees’ performance as well as knowledge transfer, which is essential in the process (Davies, Wong & Laschinger, 2011). Finally, the leader should also try to develop close ties among the team members to make them more cooperative.

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In conclusion, it is possible to note that the use of leader-member exchange and social network theories can be beneficial in the healthcare setting. These paradigms enable the leader to develop a proper relationship with the followers and create a productive environment.

Reference List

Blake, R., Mouton, J., Barnes, L., & Greiner, L. (1964). Breakthrough in organization development. Harvard Business Review, 42(6), 133-155.

Borkowski, N., Deckard, G., Weber, M., Padron, L., & Luongo, S. (2011). Leadership development initiatives underlie individual and system performance in a US public healthcare delivery system. Leadership in Health Services, 24(4), 268-280.

Davies, A., Wong, C. A., & Laschinger, H. (2011). Nurses’ participation in personal knowledge transfer: The role of leader-member exchange (LMX) and structural empowerment. Journal of Nursing Management, 19(5), 632–643.

Derue, D., Nahrgang, J., Wellman, N., & Humphrey, S. (2011). Trait and behavioural theories of leadership: An integration and meta-analytic test of their relative validity. Personnel Psychology, 64(1), 7-52.

Dine, J., Kahn, M., Abella, S., Asch, A., & Shea, A. (2011). Key elements of clinical physician leadership at an academic medical center. Journal of Graduate Medical Education, 3(1), 31–36.

Franco, M., & Almeida, J. (2011). Organizational learning and leadership styles in healthcare organisations. Leadership & Organization Development Journal, 32(8), 782-806.

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Graber, D., & Kilpatrick, A. (2008). Establishing value-based leadership and value systems in healthcare organizations. Journal of Health and Human Services Administration, 31(2), 179-197.

Hakansson, H., & Akerman, A. (2011). Daily management of a service organization. Web.

Holmes, E. (2010). Character, leadership, and the healthcare professions. The Journal of Research Administration, 41(2), 47-54.

Mobley, W., Li, M., & Wang, Y. (2012). Advances in global leadership. Bingley, United Kingdom: Emerald Group Publishing.

Nahavandi, A. (2014). The art and science of leadership. Upper Saddle River: Pearson.

Salmela, S., Eriksson, K., & Fagerström, L. (2012). Leading change: a three-dimensional model of nurse leaders’ main tasks and roles during a change process. Journal of Advanced Nursing, 68(2), 423-433.

Sin, H-P., Nahrgang, J. D., & Morgeson, F. P. (2009) Understanding why they don’t see eye to eye: An examination of leader-member exchange (LMX) agreement. Journal of Applied Psychology, 94(4), 1048–1057.

Tuan, L.T. (2012). Corporate social responsibility, leadership, and brand equity in healthcare service. Social Responsibility Journal, 8(3), 347-362.

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Wilson, K. S., Sin, H., & Conlon, D. E. (2010). What about the leader in leader-member exchange? The impact of resource exchanges and substitutability on the leader. Academy of Management Review, 35(3), 358–372.

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