In strategic healthcare management, we have learned various management theories. The following study proposes some relevant leadership theories that can be adopted at Baylor Healthcare given the issues identified in the case study. Baylor Health Care System is a not-for-profit organization headquartered in Dallas (Emswiler & Nichols, 2009). The entity is made up of a network of primary care, hospitals, rehabilitation centers, senior health centers, affiliated ambulatory surgery centers and specialty care centers. Since its establishment, the system has expanded from a single building facility to a 3000-bed integrated system that emphasizes on various quality improvement tools. The five major theories that we have learned in class relate well to the operations at Baylor Healthcare.
The first theory relates to physician leadership. As the healthcare industry battles with performance improvement, population health and clinical integration, physician leadership is paramount to achieve goals. Developing physician leaders serves as a differentiator which sets hospitals apart (Walston, 2018). Physicians play a direct role in hospitals creating and achieving organizational goals and vision. The current shift experienced in healthcare has prompted greater physician interest in leadership roles. These leaders have the potential to make a great impact across all organizational levels, in both formal and informal positions.
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Physician leadership remains a crucial component of Baylor Healthcare. The management values physician cooperation because they pay for it (Emswiler & Nichols, 2009). As the attached case study illustrates, the organization has come up with Physician Champion Programs that rewards physicians who pioneer the adoption of quality improvement projects and EHRs on a part-time basis to positively influence their peers. This is well articulated by the organization’s physician champion, Dr. Couch as he says “ It is unrealistic to expect practicing physicians to dedicate significant time to help the healthcare system advance quality unless compensated for that time .” In this statement, he implies that practicing physicians cannot dedicate significant effort and time to help the organization achieve quality unless they are compensated for that effort and time (Walston, 2018). Physicians are often resistant to outsiders trying to tell them how to do things or practice medicine. Therefore, physicians are in the best position to communicate with their fellow physicians. These professionals are more willing to change when they obtain instruction and advice from members of their field.
However, the underlying challenge is that few physicians are sufficiently equipped to handle the new leadership responsibilities. In most cases, physician leaders are tossed into their new roles without any preparation. As such, they are ill-prepared to take on the new responsibilities. Previously, the focus on physicians with likability, strong clinical skills, and high volume. However, this focus has shifted towards physician leaders with unique skills such as effective communication, buy-in across multidisciplinary teams, and capable of building trust. Knowledge of leadership skills and management training are core characteristics of successful physician leaders. Therefore, the onus falls on BHC to develop physician leaders by preparing them for the new roles. These professionals must be able to motivate, collaborate, build and move strategy in the appropriate direction to fill the physician leadership positions (Dixit, 2016).
The second theory is management leadership. The most influential people across the globe attracted world attention simply due to their ability to motivate and inspire others. Although managers may have a small sphere of influence, the managers must inspire and motivate the people if the organization is to achieve the set goals and retain the best talents (Ginter, 2013). Often, this is easier said than done. Organizations can decide to choose any managerial style at their disposal. The theories have been split into four major groups. Contingency theories are interested in the situation rather than the leader (Walston, 2018). They predict the most suitable management style that works best according to the prevailing situation. Behavioral theories focus on the leader’s actions, for instance, whether the leader takes a team approach or a dictatorial approach to achieving organizational goals (Dixit, 2016). Trait theories believe that leaders share some personal attributes and common characteristics which form the basis of their leadership.
At BHC, management leadership is critical. The Board of Trustees focuses on quality service delivery and improvement at all times. Their leadership is all about setting targets for decreasing the mortality rate and identifying participation goals that relate to quality improvement campaigns like the Institute for Healthcare Improvement’s 100,000 Lives. The managers take a team approach when introducing initiatives, which helps in the sense that the physicians have been able to take initiatives seriously (Walston, 2018). In fact, something that is of priority to the Board and management becomes a priority to the rest of the organizational members, too.
The third theory relates to change management. The focuses on how the organization equips and supports its people to successfully adopt a change to drive the desired organizational outcomes and success. Although all change initiatives tend to be unique, research indicates that organizations can take certain actions to influence its people in their transitions. The concept of change management offers a structured approach for organizations to support their people in handling future challenges.
Moreover, organizations must learn how to approach change. BHC insists on identifying goals and then mapping out a pathway to success. The organization uses John P. Kotter’s eight step-model of change management (Ginter, 2013). These stages include creating a sense of urgency, establishing a powerful coalition, developing, communicating and empowering employees to implement a vision, create short-term wins, consolidate improvements and make the changes tick. The company believes that the most successful leaders follow these stages when introducing change (Dixit, 2016). The bottom line is, the change process demands that leaders across the organization engage in a continuous learning process to enact the desired change in an organization.
The fourth theory relates to the establishment of a learning organization. In the era of increasing consumer power and rapid technological advancements, it is clear that for an organization to survive, it must emphasize on continuous organizational learning (Walston, 2018). Regardless of the business size or industry, every organization must forge ahead in learning faster to remain relevant. In this respect, the ABC-Baylor program was created to teach physician champions, board members, administrators and others the approaches required to improve their outcomes and seek new solutions (Emswiler & Nichols, 2009). These educational efforts concentrate on how to examine cause and effect, the PDCA method and other analytical tools. These educational initiatives enable the graduates of ABC-Baylor to introduce their quality improvements.
Such an organization encourages employee participation in the change management process across all levels of workers and managers. Here, change is often managed considering the core values and mission of the organization. Further, the leadership aligns all processes as per these values. Therefore, BHC has molded itself as per the market needs and its procedures have been parallel with the changing market environment (Walston, 2018).
The evidence-based medicine and the theory of knowledge are also relevant to the operations at BHC. The theory recommends that medical practitioners must use evidence from properly designed and documented research. Although all practice based on science has some aspects of empirical support, evidence-based medicine and knowledge go further to classify evidence according to its strengths and requires that only the strongest research findings be used to make medical recommendations (Ginter, 2013). BHC has the best Care Committee that serves as the clinical authority for the entire organizational system. Therefore, its research, decisions, and deliberations are based on the tools Physician Champions use to enhance the quality of care that the organization’s patients get. Additionally, all data regarding evidence,-based medicine is often available to Physician Champions which allows them to work with their peers.
Evidence-based practice is at the heart of what physicians do at BHC. It forms the ground for decision making and focuses on the leadership. Applying solid evidence to practice good physician services remains the cornerstone of clinical practice at BHC. Failure to adhere to evidence-based practice is likely to attract grave consequences (Dixit, 2016). Given that patients suffer from straying from a loosely defined care standard, which is often evidence-based, then, the organization may find itself confronting a set of dreaded malpractice lawsuits. Moreover, given that physicians do not meet specific evidence-based metrics, then, their paychecks are likely to suffer (Walston, 2018).
Overall, it is evident that BHC has implemented various theories successfully in its operations. It has used them to improve their operations and service delivery. As a result of these integrated initiatives, BHCS’s Board of Trustees and the physicians have been able to fulfill the organization’s mission, the hospital mortality rate has dropped, and patients now receive more preventive services. Importantly, the delivery of care at BHC has been standardized over the last few years than in the past.
References
Dixit, S. K. (2016). Strategic management in hospitals – Theory and practice: Orthopedic and spine services. International Journal of Healthcare Management, 9 (3): 181-189.
Emswiler, T. & Nichols, L.M. (2009). Baylor Health Care System: High-Performance Integrated Health Care. Commonwealth Fund Publication 1246, 10 : 1-20
Ginter, P, M. (2013). The strategic management of health care organizations. New York, NY: John Wiley & Sons.
Walston S. L. (2018). Strategic healthcare management: Planning and execution . New York, NY: Health Administration Press.
