The health care environment has unique issues because of its distinctive features, making it complex and dynamic (Garman & Scribner, 2011). These issues include shortages of personnel, the influence of different stakeholders such as social and political groups, internal pressures due to high demand for accountability and transparency, turnover, medical errors, and increasing cost of services among others (Cheryl Lacasse, 2013). Other external factors such as advanced medical and information technologies, government policies, globalization, economic factors, and changing population demographics also significantly affect the sector (Gertner et al., 2010). The interplay of these cause the sector to undergo regular changes to address the expectations of all the stakeholders while ensuring the provision of effective, safe, and quality care to patients.
Given the dynamic and complex nature of the health care environment, strong leadership is required to ensure an efficient and effective health care system. The current paper explores the type of leadership required in the healthcare sector by using the Competing Values Framework to assess the organizational culture and leadership in the sector based on the issues that the sector experiences. The paper will then recommend the best leadership style required in the health care sector.
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Organizational culture in the health care setting emerges due to shared values, behavior patterns, and attitudes that medical professional experience in the process of delivering health care. Recent studies about culture in the hospital settings highlight the significance of culture for positive organizational outcomes (Mahran, 2016). A positive organizational culture influence workers in to increase their commitment to a culture of error sharing and error reporting, which enhances patient safety and reduces mortality rates (Jafree, Zakar, Zakar & Fischer, 2015). Effective leadership is required to shape organizational culture and influence the implementation of changes in the health care sector. The increasing interests of studies in the ideas of health management and leadership demonstrate the significance of effective leadership (Quinn et al., 2015). Currently, studies are focused on identifying and assessing essential competencies that health managers and leaders require to perform effectively in their roles (Quinn et al., 2015). It is vital to identify these competencies to initiate appropriate professional development that can be used to improve individual competence and enhance performance in health care organizations.
Most health care organizations use the competing values framework (CVF) for research to assess their culture and predict outcomes such as professional and patient satisfaction, team building, and quality improvement. The framework synthesizes organizational theories by characterizing organizations in two domains, which include flexibility-stability and control and internal environment-external environment. Each domain reflects alternative ways of resolving challenges to ensure functionality (Quinn et al., 2015). The first CVF domain, flexibility-stability and control, concerns the extent to which organizations focus on flexibility and decentralization versus control over process and centralization.
The second domain, internal environment-external environment concerns the extent to which organizations orient towards the external settings and associations with external stakeholders including customers, partners, competitors, suppliers, and regulators, versus their internal processes and settings. The cross-classification of organizations based on these dimensions lead to four archetypes, which include clan, adhocracy, market, and hierarchy cultures (Quinn et al., 2015). Organizations with hierarchical cultures focus internally while emphasizing control. They also use centralized authority over organizational processes, respect formal hierarchy, and follow rules. They also focus on predictability and stability. Here, leaders act like coordinators. Organizations with clan cultures focus internally while emphasizing flexibility. They facilitate employee participation, highlight empowerment and teamwork, and prioritize human resource development. Leaders here act like father figures. Organizations with adhocracy cultures focus externally while emphasizing flexibility. They also demonstrate innovativeness and creativity and highlight growth and resource expansion. Here leaders stimulate innovation. Organizations with market cultures focus externally while emphasizing control. They have clear goals and tasks and focus on measurable results and efficiency. Leaders here act like hard drivers.
Studies about CVF culture types suggest that a single culture is not ideal in health care settings. All cultures can be present even though a dominant culture will emerge based on leadership. Research, however, shows that organizations with dominant hierarchical cultures focus on status hierarchies, regulations, rules, and target setting, which do not lead to good performance (Hartmann et al., 2009). The creation of a strong entrepreneurial culture, in contrast, enhances innovative approaches to solving issues, group learning, and initiative-taking. These outcomes inform actions in addressing issues related to patient safety. Emphasizing control, policies, rules, and hierarchy hinder a positive safety climate because of concerns about adverse outcomes and blame for reporting issues related to safety.
Healthcare organizations move through changes based on different environmental features. The versatility and flexibility of the organizations shape their course to allow them to develop different strategies. Health services also evolve based on the defined strategies as a response to population needs. The CVF allows organizations to visualize how their culture and leadership work. Stakeholders in the healthcare system including patients, physicians, and nurses among others have interdependent roles. In these settings, leaders who just offer directions to be followed will be unsuccessful. The leadership style required here focuses on collaborative work in which others are considered to be full partners through mutual respect (Quinn et al., 2015). Being a full partner surpasses all levels of any healthcare profession and necessitate leadership competencies and skills that should be used both within the profession and in partnership with other medical professionals. Being a full partner in the healthcare settings entails being accountable for identifying issues and avoiding wasting resources, designing and implementing improvement plans, tracking progress periodically, and adapting to the existing environment to reach set objectives. Reduced turnover, decreased medical errors, and enhanced patients outcomes are attained because of this leadership style (Jafree et al., 2015). Other positive outcomes of due to this leadership style include decreased workplace bullying and disruptive behavior, improved teamwork, high job satisfaction, cost savings, and decreased length of hospital stay. Many health care organizations, nevertheless lack inter-professional collaboration and changing this culture is challenging.
A strong entrepreneurial leadership style should be the norm in the health care sector. The required leadership style should touch all areas at all levels in which both patients and other stakeholders in the healthcare system engage executives, subordinates, and colleagues to identify and attain common objectives. All health care team members must contribute by collaboratively managing their practice. For example, nurses, physicians, and other medical experts must work collaboratively to avoid hierarchical hindrances and hold each other accountable for enhancing the quality of care and reducing medication errors and adverse events.
The complex and dynamic nature of the health care sectors is characterized by regular reforms and changes. In these settings, the overall culture should foster a strong entrepreneurial culture because this encourages innovation that leads to positive patient outcomes. Strong entrepreneurial leadership is required to offer direction through the various interacting factors to implement the necessary changes to ensure the delivery of efficient and effective health care. Research shows that a leadership style that enhances group orientation while decreasing hierarchy encourages participation of all stakeholders in the healthcare sector in problem-solving and decision making, which enhances the operational success of the healthcare sector.
References
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