Effective leadership especially in an organization providing healthcare is important and should emphasize continually that safe, high quality, and compassionate care is the top priority. To achieve this, many principles include a mission, vision philosophy and leadership styles that help the organization meet its overall goals, maintain a functional structure and use resources efficiently. In organizations providing healthcare, leadership styles range from democratic leadership, transformational leadership, transactional leadership, and etcetera. An organization was selected to elucidate the various principles and benefits that certain leadership styles contribute to healthcare delivery. The organization identified was Comfort Care Hospice LLC.
Comfort Care Hospice LLC is not a national chain or big corporation but has 18 branches in the state. The patients they serve are mostly their neighbors and care is delivered even at the comfort of the patients’ own home. Its mission is to serve patients and families with excellent care, generous support and compassionate attention. A hospice generally is an institution that focuses on palliative care for the chronically ill, terminally ill or seriously ill patients with pain. It also attends to the emotional and spiritual needs of their patients. In Comfort Care Hospice LLC, the core values are excellent patient care, patients come first and all employees are treated like family. The hospice organization was chosen because of familiarity with the organizational structure. Comfort Care Hospice LLC offers supportive, holistic care that is centered on individualized treatment plans. The self-worth of each patient and the right for them to be in control of their healthcare decisions in whenever possible is a large part of the organization. This company is deeply rooted and valued in the community. Comfort care hospice is very active in community participation with events.
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Schein defines culture as,” a pattern of shared basic assumptions learned by a group as it solves problems of external adaption and internal integration, a product of joint learning. Comfort care hospice LLC is comprised of a board of directors. It has a dynamic organizational climate. This is because it is part of a larger entity; the restore management. Under this entity are hospices, home health, durable medical equipment companies and therapy services. Comfort Care Hospice LLC promotes a supportive environment with the commitment to keep all the employees informed s the best decisions can be made. The chief operating officer is hands-on and visits every branch periodically and can easily be reached on the phone. Any issues that may arise go through the board of directors. The quality improvement team and compliance officer are also involved in decision making should issues arise. The employees are very receptive to changes within the company because of the openness and the value the company recognizes from their input. One of the main things they point out is that they are not the ones carrying out the defined activities the auxiliary staff is, and they want to know what works, what doesn’t work and what needs improvement. Organizational learning is an ongoing process in this organization with the predominant leadership style being transformational leadership mixed with democratic. Basically, Comfort Care Hospice LLC as an organization still has its mission, philosophy and values alive and well. Comfort Care Hospice LLC is highly regarded by the community it serves. One relative to a patient in the organization says,” if I were asked to rate Comfort Care Hospice LLC on a scale of 1 to 10, I would give it an 11!” At Comfort Care Hospice LLC, they have a philosophy to make every patient live each day to the fullest. The chief operating officer- Lisa Teel once said, “We may not be able to change the outcome, but we can change the journey.”
Transformational leadership is where the followers see their leader’s behaviors, and are inspired by them to change and be better. They see concern from their leaders for their well-being as well as hard work. The leaders exhibiting this leadership styles perform beyond all expectations because they put in more effort than usual (McKeown & Carey, 2015). They put the organization’s best interests first before their interest. Old assumptions and traditions are questioned to come up with new ideas that help solve problems more effectively (McCleskey, 2014). The leader provides a clear vision of the future that motivates staff members to exceed themselves. The degree to which a leader is transformational is measured first by his influence to the followers or team members. Team members in an organization led by such a leader feel trust, admiration, loyalty and respect for the leader and because the leader is willing to work harder than is originally expected. These kinds of positive outcomes from the team members occur because the leader offers something more than just working for self-gain- they offer inspiration on a mission and vision that gives the team and organization an identity.
There are four elements of transformational leadership that define it and provide a clear way to utilize the leadership style effectively. First, the leader should give individualized consideration in that, he/she attends to each member’s needs, acts as a guide and listens to the member’s needs ( Žydžiūnaitė, 2015). The leader also gives support and shows empathy in addition to open communication and celebrating individual contributions towards the team. Second, the leader seeks to intellectually stimulate the members by challenging assumptions, taking risks and soliciting members’ ideas. This is with an aim to foster creativity, encourage learning and critical thinking to devise better ways to execute their tasks. Leaders have the critical role of articulating a vision that is appealing and inspiring to the members. They challenge the followers with high standards, communicate optimism about future goals and provide meaning for the task at hand. This encourages members to invest more effort in their tasks and be optimistic about the future and believe in their abilities. Finally, the leaders should influence members on having high ethical behavior, instill pride, respect and trust.
In Comfort Care Hospice LLC, the Chief Operating Officer embodies a transformational leader in that; she is charismatic, engaging, inspirational, optimistic, honest, respectful, positive, team-oriented, reliable, and a visionary. It is important for persons in place of leadership especially in healthcare to be familiar with the various organizational leadership styles and decide which leadership style best reflects their values (Pullen Jr, 2016). Transformational leadership has a direct effect on staff and customer satisfaction in an organization such as a hospice. Increased satisfaction among nursing staff in a hospice leads to an overall decline in staff turnover, improved retention, and an upsurge in patient satisfaction. There are also downsides to the transformational leadership style in an organization such as a hospice in that, team dynamics can differ dramatically from one hospice to another, and therefore one approach of transformational leadership may work for one but not the other (Pearsall et al., 2014).
If the leader finds that gathering the entire team in one place to discuss making decisions leads to lack of participation and conflict, then this style may not fit right. Sometimes the team in a hospice gets caught up in the passion of the very inspirational leaders believing the leader can make a big difference in their lives which may not be the case (Wylie, O’Neill, Miller, & Jackson, 2017). When passion overtakes reality, the outcome is not always great. In nursing management and especially in an organizational setting such as a hospice, transformational leadership plays a vital role. Healthcare in the United States is relentlessly changing, and so is the hospice industry. The American Nurses' association continues to encourage and support nurses to take management roles in various settings in which they practice. In a hospice with nurses in positions of leadership, they should promote teamwork among staff, encourage positive self-esteem, motivate the team to work at a high level of performance and empower them to become involved in the development of quality health provision (Choi, Goh, Adam, & Tan, 2016).
Democratic leadership, on the other hand, encourages the team to speak up and join the decision-making process. It involves open communication among all staff members and ensures every voice matters (Cox, 2016). The leaders are more concerned about the things that go on in the organization knowing that they can influence situations if they act on them. Every team member is given a specific responsibility and is accountable for reaching specific targets. After completion of every task, performance feedback is given allowing them to adjust accordingly. Although the final decision is made by the leader, the leader collects information, views, and ideas from all the staffs before finalizing everything. It is quite effective in that all the employees feel valued, and due to this, they attempt to give the best (Fowler, 2016). This is one of the best leadership styles in clinical settings as skills and aptitudes of all the professionals contribute correspondingly to the success of the organization.
Generally, the focus in the democratic style of leadership is on improving the quality of the systems and processes, not on finding errors made by the individual team members. In healthcare, the use of the democratic leadership style promotes the sharing of responsibility, the exercise of delegation and regular consultation in clinical skill and practice (Caillier, 2016). It is the role of the leader just like in Comfort Care Hospice LLC, to seek consultation on all major issues and decisions. The leader should delegate tasks and give the team members full control and responsibility for those tasks. The chief operations officer at Comfort Care Hospice LLC welcomes feedback on the work environment and inspires others to become leaders and be involved. The downside to using this leadership style is that a lot of time is consumed in decision making, there's a danger of pseudo-participation since healthcare providers have different skill levels, it may not be appropriate.
The core competencies of interprofessional collaborative practice (IPEC) domains include utilization of informatics, provision of patient-centered care, application of quality improvement and employment of evidence placed practice. Interprofessional collaboration competencies are strongly supported by Comfort Care Hospice LLC since all employees believe in a moral obligation of working together to improve care for patients. There is shared acknowledgment of each participating roles and abilities showing competency domain number two that call for roles and responsibilities is upheld. Without this acknowledgment, adverse outcomes may arise affecting the effectiveness of teamwork. From the mission and vision, we derive the fact that the hospice aims to provide patient-centered care and application of quality improvement services which are part of the core competencies for interprofessional collaborative practice in the US. In conclusion, Comfort Care Hospice LLC is strongly supported by the leadership of the organizations in that all the four competencies of interprofessional collaboration are upheld.
References
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