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Leadership and Management in the Patient-Centred Care

The terms of leadership and management are often used interchangeably within the nursing environment. Both leadership and management are crucial for high-quality delivery of health services (Francis, 2013). Though these notions are often seen in the same respect, they differ in behaviour, skills, or perspectives. Both qualities are demanded to engage in the changing health delivery system (West, 2015). Even though the terms appear to be similar, there are some distinguishing features between them.

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It is logical to mention the Francis Report, which explores what factors of healthcare led to reduced services provision, medical failures, and why the staff could not express their opinion explicitly. Two hundred ninety recommendations presented in the report are aimed towards ameliorating patient care outcomes (Francis, 2013). The report drew particular attention to leadership and management at each level of the healthcare system and how it can bring about openness, integrity, and transparency. (Francis, 2013). The leadership in NHS encompassed not only motivation but also an open environment, long-term vision, and the ability to implement a specific leadership style in correspondence with a situation. Finally, the report suggests that both management and leadership are the essential elements in promoting an organizational culture where patients’ values and needs come first and are understood at each level.

Leadership can be defined as an interactive process where the followers are encouraged and empowered to pursue the same goal. Moreover, it implies influence and comprises of interpersonal skills of one to urge others to achieve specific goals (Cutcliffe and Cleary, 2015, p. 820). Within the health care environment, leadership is a multifaceted process aimed to support, motivate, effectively communicate, and coordinate to attain positive outcomes (Francis, 2013). An effective leader has a set of qualities, including courage, initiative, resistance to stress, and integrity (Figueroa et al., 2019, p. 7). According to Stanley (2017, p. 95), “leadership has more to do with aligning people, setting direction, motivating, inspiring, employing credibility, adopting a visionary position, anticipating change and coping with change” The statement implies that leadership is the core of any organisation as its essence is directed towards motivating, setting goals, keeping subordinates on track, innovating and communicating visions and values.

Different styles of leadership exist, and an efficient leader must know when to resort to one or another. The Appendix 1 states that the nurse-in-charge delegated the straightforward tasks to nurse Z, a student nurse and health assistance. This type of leadership is named autocratic as it implies the distribution of individual orders to each member of a team and taking full responsibility of making the decisions (West et al., 2015). Democratic leadership is another style which assumes collecting the feedback from the subordinates in order to make a final decision with the manager. Such guidance urges open communication and reciprocal response. Referring to Appendix 1, it is evident that the nurse coordinator, trying to stabilize the patient’s condition, informed the registrar who sent out a haemorrhage team. When the haemorrhage and the cardiac arrest teams came to the chamber, the chief nurse told them of interventions and received feedback about the medical decisions from those team. A leader can also be transpersonal, that is, a person who is emotionally intelligent and caring, ethical, and can build strong collaborative relations within a team (Knights, 2018). The case study given in Appendix 1 suggests that the nurse manager, being a leader, managed to gather a team and build the proper atmosphere within it.

In addition to the leadership styles, the transformational one plays an important role within a sphere of healthcare delivery. Transformational or visionary leadership in medicine stands for thinking big in terms of improving patient care, quality changes or system reformation (Scully, 2015). The primary goal of such guidance is to inspire and incite a team, therefore increasing job performance. Thus, alluding to Appendix 1, it is observed that the nurse manager managed to save the situation by guiding her subordinates in the right direction. What is more, the role of a transactional leader is also essential due to its focus on organisation, orders, and performance (West et al., 2015). Such form of leadership has compliance with the rules as a priority, thus, presumes punishing or rewarding. Therefore, the Appendix 1 suggests that the nurse manager and her followers immediately ran to the site with a crash trolley and took all the possible actions to prevent a life-threatening situation.

Another essential element in a healthcare organisation is management that can be defined as a controlling mechanism that keeps all the systems in order. Managers of any organisation are typically involved in budgeting, coping with complexity, staffing, and other activities (Jha, Sahay, and Charan, 2016). Stanley (2017, p. 95) states that “management is indeed co-dependent with complexity, and modern management has evolved because without good management, large organisations and complex enterprises tend to become chaotic”. Moreover, managers are less emphatic and proactive because they tend to focus on the problem-solving process, planning and analysing (Naranjo-Gil, 2015). Managing primarily concerns the status which can guarantee a stable position and give one more power that a leader gets (Oppel, Winter, and Schreyogg, 2017). It is thought to be a matter of title; therefore, managers may be driven by it, thus acting not out of their will but out of necessity. Active managers establish the quality and profitability of the company as their goal is to provide consistency and order.

In conclusion, it seems reasonable to state that despite a slight difference between leadership and management, both concepts are crucial in sustaining the ever-changing sphere of healthcare services. Leadership is about motivating and guiding people leaning on interpersonal relations, whereas management represents an elaborate system of controlling the staff.

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Reference List

Cutcliffe, J. and Cleary, M. (2015) ‘Nursing leadership, missing questions and the elephants in the room: problematizing the discourse on nursing leadership’, Issues in Mental Health Nursing, 36, pp. 817-825.

Figueroa, C. et al. (2019) ‘Priorities and challenges for health leadership and workforce management globally: a rapid review’, BMC Health Services Research, 19, pp. 1-11.

Francis, R. (2013) Report of the Mid Staffordshire NHS foundation trust public inquiry. London: The Stationary Office.

Jha, R., Sahay, B., and Charan, P. (2016) ‘Healthcare operations management: a structured literature review’, Decision, 43(3), pp. 259-279.

Knights, J. (2018) Becoming a transpersonal leader. London: Routledge.

Naranjo-Gil, D. (2015) ‘The role of top management teams in hospitals facing strategic change: effects on performance’, International Journal of Healthcare Management, 8(1), pp. 34-41.

Oppel, E., Winter V., and Schreyogg, J. (2017) ‘Evaluating the link between human resource management decisions and patient satisfaction with quality of care’, Health Care Management Review, 42(1), pp. 53-64.

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Scully, N. (2015) ‘Leadership in nursing: the importance of recognising inherent values and attributes to secure a positive future for the profession’, Collegian, 22(4), pp. 439-444.

Stanley, D. (2017) ‘Clinical leadership in nursing and healthcare: values into action’, in Stanley, D. (ed.) Leadership and management. London: John Wiley & Sons, pp. 91-105.

West, M. et al. (2015) Leadership and leadership development in healthcare: the evidence base. London: The Faculty of Medical Leadership and Management.

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