Leadership Theories, Innovation And Change Management In Healthcare
Importance of Leadership in Healthcare
Discuss about the BSc Leadership and Innovation Module 2018.
Regulatory systems increased market competition, and fixed targets are unable to bring the necessary fundamental changes required to face the challenges of the healthcare system. Therefore, there are changes in each aspect such as cultural, operational and service should be brought about so that improvement in the continuous delivery, quality and patient concerned care (Burke, 2017). Hence, leadership is an important aspect that helps to drive the organization and associated professionals to bring the necessary changes within the organization and maintain stability and sustainability while the change management is implemented (Fullan, 2014). Leadership is always associated with innovation as while setting a direction for the growth of the organization, they implement several innovative ideas that inspire associated professionals to achieve the prime goal. Innovation bears supreme importance, as in the phase of globalization, where each industry including healthcare sector is shattering boundaries, innovative skills, and processes has become the prime driver of value, growth, and performance of the employees (Burke, 2017). This process of improvement and development is known as change management and the strategies of change management are implemented to effective, controlled and easily adaptive change.
Medication error is one of the biggest shortcomings of the modern medication system as increased patients, a variety of diseases and preventive measures lead the healthcare professionals to commit mistakes unintendedly (Bonkowski et al., 2013). Therefore, this assignment is proposing the usage of Barcode Medication Administration (BCMA) in one of the busiest unit of the hospital, the renal unit. In this assignment, the two leadership theory needed for the implementation of change in healthcare facility will be discussed with their strength and weakness. Further, the importance of innovation in the health sector will be described with the SWOT model. Finally, the change management will be discussed and two change theories will be included in the assignment and evidence will be used to link theory with the practical practice.
For a successful change management process, there are six steps that need to be followed so that compliance to the new process can be achieved. These steps are managing support for introducing change to the employees as well as customers, deciding the primary target for change and seek employee assistance for implementation and finally taking follow-ups after implementation of the change in the process (García-Morales, Jiménez-Barrionuevo & Gutiérrez-Gutiérrez, 2012). Hence, leaders are also at pressure while conducting change management as while going through the change process, employees seek assistance, accountability, clarity, and connection from their leaders. Therefore, it is important for the healthcare organization leaders to implement leadership theories so that the change management process becomes easier and convenient for the healthcare professionals (Carter et al., 2013). There are two leadership theories that the leaders should implement while implementing change in the process, such as the behavioral theory and the situational or contingency theory.
Behavioral Theory of Leadership
Human behavior is an important aspect that is reflected while the person goes through pressure or implements any change in his/her personal or professional life. This change in behavior is influenced by persuasions, hypnosis, culture, attitude, and coercion (Dinh et al., 2014). The person who is able to control all these aspects of behavior while going through pressure has the traits of leadership. The behavioral theory of leadership is defined as the process, in which the observable actions and respective reactions of the leaders as well as their followers or employees are assessed for a specific situation (Leroy, Palanski & Simons, 2012). This theory believes that every person can learn skills and attitudes that can make them leaders and it is the learning capacity of the leaders that decide their efficiency while introducing change in the organization (Parris & Peachy, 2013).
The strength of this leadership theory is associated to its value that enhances the people collaboration and has an emphasis on the relation between leaders and its followers, which is an important aspect while going through change management process (Kark & Shamir, 2013). Further, as the leaders are open for learning and gaining knowledge from everywhere, they let employees to participate in the decision-making processes and put forward their views regarding the implementing change in the process (Dinh et al., 2014). This made them more flexible towards their employees and understand the situations that can hamper the relationship between leadership and employees (Van De Voorde, Paauwe & Van Veldhoven, 2012). Further, this behavioral theory let leaders understand the concerns of each stakeholder associated to it (such as in the proposed change, implementation of the barcode can affect patients and healthcare professionals) for increased productivity (Parris & Peachy, 2013).
The prime limitation of this process is associated with the acquired attitude and behavior of the leaders. As the leader acquired the attitude and behavior from the different situational pressure it might possible that he or she is unable to take an appropriate step in each situation and enact according to the theory properly (Dinh et al., 2014). This is more challenging as adapting to the acquired behavioral change correctly each time, is psychologically not possible. The second limitation is related to the adaptability of the leader to the given situation, cultural situation and organizational aspects. There is a less amount of theory present that demonstrate the appropriate behavioral trait that the leader should acquire while going through cultural conflicts, and problematic situations in the change management process (McCleskey, 2014). The prime reason behind this can be the subjective nature of behaviors as one person’s behavior in one situation can differ from someone else’s reaction (Parris & Peachy, 2013).
Strengths and Limitations of Behavioral Theory
The management style of leaders has a direct and proportional effect on the failure and success of the organization or the employees, who struggle to achieve success for the company (Villoria, 2016). This theory determines that the leadership is the personal trait of people, and does not change with every coming challenge (McCleskey, 2014). According to this theory, dominant nature of leaders are helping them to achieve task-related and human-relation related tasks and the followers also feel influenced and inspired to achieve the target for the company (Waters, 2013). This leadership theory is beneficial in extreme situation, when sudden change management related to an important process of the company is implemented (Van de Ven, Ganco & Hinings, 2013).
As the leadership style focuses on domination of the leader while going through change management, the most important strength of this leadership style is that it makes the employees responsible for their own decisions and actions (Villoria, 2016). Further, as the leadership style focuses on the discussion with experienced and tenured employees regarding their views, a sense of accomplishment will be created in the tenured employees of the organization, which will lead them to deliver their tasks honestly and eventually achieve the goal for the organization (Hanisch & Wald, 2012).
However, this dominant trait is the weakness in a few situations. Job readiness and ability to adapt to the change is different for different people, hence, dominance can lead them to break down and their entire work performance can collapse (Waters, 2016). Further, wrongly applied pressure can let employees leave the organization which eventually harms the organization as fresher or new worker will not be able to produce the desired productivity while going through the change management process (McCleskey, 2014). Further, as this leadership skill is abusive, the followers may willingly quit working and performing tasks that affect the change management by delaying the process, as well as affecting the accountability, productivity, and efficiency of the associated employees. Furthermore, according to Wright, Moynihan & Pandey (2012), while working in a healthcare organization going through change management process, it is quite impossible to apply one style of leadership skills as each situation brought different difficulty for which different leadership traits and solutions are required. These are the strengths and weaknesses of this leadership theory (Van de Ven, Ganco & Hinings, 2013).
Within these two leadership theories, to implement the change related to usage of Barcode Medication Administration in the renal department of healthcare organization, the situational or contingency theory of the leadership has been chosen. The reason for choosing this leadership theory for the implementation of change management related to the process is associated with the personal trait of the leader (Carter et al., 2013). As the behavioral theory described that leaders acquire attitudes towards issues while suffering from similar situations. However, it is possible that similar situations require different reactions in two different situations, hence, in such situation, a strong and dominant leadership is required who can lead the followers through tough situations (Van De Voorde, Paauwe & Van Veldhoven, 2012). Further, as the contingency theory, focuses on boardroom discussions with employees, and creating a roadmap for implemented change, its efficiency increases compared to the behavioral theory (García-Morales, Jiménez-Barrionuevo & Gutiérrez-Gutiérrez, 2012). Hence, for the proposed change management, the contingency or situational theory will be applied.
Contingency Theory of Leadership
Innovation is a critical aspect for organizations, as it helps to increase the business-related productivity and enhance the chances of survival in the competitive culture (Weber & Rohracher, 2012). Especially in the healthcare system, innovation increases the quality of the process and enhances the reliability of patients and service users within the process. There are two types of innovations related to different aspects of healthcare process such as product innovation and process innovation (Bock et al., 2012). Product innovation in health care is related to new medication and instruments that help to easily diagnose and provide faster recovery from the disease, whereas the process innovation enhances the capability of associated healthcare professionals so that they can utilize the newly innovated products for the betterment of the patients (Weber & Rohracher, 2012).
The role of the working environment also determines the level of compliance of the employees towards the proposed change as it can increase or decrease the capability of people to combat the difficulties while change management (Kumar et al., 2013). SWOT analysis is one such process using which the management of any organization is able to understand the external and internal factor that can affect the future performance of the company (Sevkli et al., 2012). SWOT is comprised of Strengths, Weaknesses, Opportunities, and Threats and it helps the management and leadership of the organization to determine the external and internal environmental issues that can affect the performance of the employees and the company (Agarwal, Grassl & Pahl, 2012). Further using the SWOT analysis organizations can determine their financial expenses and set up the operation related goals as well as helps to set up strategies that will be useful in creating the strategies to achieve the goals (Sevkli et al., 2013). Within the four aspects, strengths and weakness are determined as the internal factors of the organization, whereas the opportunities and threats are the external factors that depend on the outer responses of the organization (Al-Araki, 2013). Hence, usage of SWOT analysis is a useful tool in determining the strengths and weaknesses of any organization and associated aspects of it.
While describing the usefulness of SWOT analysis few aspects of it’s should be mentioned. Firstly, using SWOT analysis, the organization is able to use the resources efficiently. It is a fact that despite the bigger size and reach of any company, their manpower, their capital investment and the ability of production are limited (Kajanus et al., 2012). While assessing the details of these strength factors helps the company to implement a strategies usage of these resources so that they can generate higher number of revenue from this. Further, it also helps the company to identify the opportunities such as a broader marketplace or customer groups and it is important for the organization to respond to that accordingly (Romero-Gutierrez, Jimenez-Liso & Martinez-Chico, 2016). The third usefulness has increased the ability to combat with the upcoming risks using the defensive strategies and contingency plans. Finally, the mention of competitive advancement should also be mentioned as there are organizations that perform a SWOT analysis to determine and locate their threats (Adebanjo et al., 2015). Therefore, SWOT analysis is an effective tool for the organizations of any background that helps the organization by determining their internal and external issues and provide them, with the opportunity to revive the system.
Strengths and Weaknesses of Contingency Theory
While the change management process, the strength of the working environment is regarding the competitive and adjustable nature of the employees. These two aspects help the organization to take necessary steps while implementing change. Further, a fixed target of the working force, local support, and presence of professional employees are strengths of working environment (Opsahl, George & Gann, 2012).
Excess workload, leader’s pressure, and unsupportive working environment are the primary weakness that affects the change management process by delaying its speed. Further, as the entire process related to the tasks are changed, employees take time to acquire the knowledge regarding the new process prior to speed up their production (Somech & Drach-Zahavy, 2913).
The most important opportunity that the working environment in the midst of change management the organization has regarding the relation between leader and its followers. It helps to enhance the effective communication skills, enhance the employee’s ability to withstand pressure with training and development programs (Bock et al., 2012).
As the working environment in change management process is full of domination and work pressure, the chances of resignations from the employees’ increases and new or fresh workforce may take time to understand the process and implement change, creating a lag in the change management plan (Opsahl, George & Gann, 2012).
The prime implication of change regarding usage of barcodes instead of paper works regarding the medication administration of patient is decreased amount of medication errors, which usually causes more than 65% of patient worldwide (Weber & Rohracher, 2012). Further, as the nursing and healthcare professional will be using barcode and associated electronic medication administration record system, it will be easier for the patient and the healthcare facility to keep the patient data securely. The staff interpersonal communication also increases (Bock et al., 2012). For example, while implementing Barcode medical administration in the renal unit of the healthcare facility, if the healthcare professionals and staff support the hospital authority, the authorities will be able to take further harsh steps for the overall growth of the organization (Weber & Rohracher, 2012).
Change is a specific idea or notion that helps to improve the condition of organizations and combining with different theories it helps to create new concepts of change, implementing which can help the leaders to transform the process completely (Burke, 2017). On the other hand, change agents are people who help the organization by transforming or improving the process and the effective communication within the system. The change agent can be anyone who helps to drive or influence people to accept the new system or program inside the process and helps to develop or improve the process effectiveness (Fullan, 2014). For better management of the change applied in the healthcare organization, different change management models are present, within which, two has been presented in this study.
Proposed Leadership Theory for the Implementation of Change
According to Cameron and Green (2015), Rodger’s described four elements as driving force to diffuse newer ideas and inspiration while implementing change and these are Innovations related to new ideas, project, object and practice, effective communication, time to determine accurate decision-making and solving problems in groups so that goals can be achieved with cumulated force (Cameron & Green, 2015). In Rodger’s model of change, there are five kinds of people in every organization, and depending on their level of adaptations, the change can be implemented within the organization. The categories are innovators, early adaptors, early majority, late majority, and laggards. The innovators are the one who primarily adapts the change and willing to take the risk for the benefit of the company, early adaptors are the group of people who based on evidence, join the change management willingly (Benn, Dunphy & Griffiths, 2014). Early and late majorities are in a neutral position in case of joining change management whereas the laggards are people who join the change process at last, unwillingly. Hence, this model believes that each employee will take their own time to implement change and organization should provide them time to adjust to the new process (Cameron & Green, 2015).
This model of change is comprised of three steps such as unfreezing, change and refreezing, which makes it easy to apply and implement in any organization irrespective of its complexity (Burnes & Cooke, 2013). Unfreezing determines the preparation stage of change management by informing the employees regarding change and seeking their valuable feedback so that their complete support can be achieved. This step challenges the belief, values, attitude, and behavior of the employees, current practices so that newer model and process can be implemented (Shirey, 2013). The second step, which is change and in this, people set their minds and try their best accept to the change and implement a newer process in their work system. In this step, the leaders of the organization try to solve all the issues of employees while adapting to the change. Finally, the third step refreezing is applied to the organization, as this determines that all the employees are accustomed to the new process and are ready to perform for the betterment of the organization (Burnes & Cooke, 2013).
To implement the proposed change in the desired healthcare organization, the Kurt Lewin model of change has been selected. According to Cummings, Bridgman, and Brown (2016), change is a process that should be done with the consent of the involved people so that resistance can be minimized. The Lewin change management model’s first step, Unfreezing is about informing the associated people about the change in the process so that they can prepare themselves for the newer challenges mentally (Burke, 2017). Further, as the nurses are the change agents in this model of change, their adaptation to newer changed process is necessary and Lewin model provides them with numerous support from the administration and senior healthcare professionals to understand the new process (Fullan, 2014). Therefore, to implement a barcode medication administration process in the renal unit of the hospital, the Kurt Lewin model of change has been implemented. For example, providing nurses with training related to BCMA while implementing change and undertaking several assessments related to the practice will help them to acquire the process completely and the chances of medication errors will be minimized (Cummings, Bridgman & Brown, 2016).
Importance of Innovation in Healthcare
Further, for the management of change, the hospital authorities should assess the state of the renal department and the rate of medication-related error in the unit. This will help them to identify the problems and convince the agent of change that is the nurses to adapt to the newer practice (Appelbaum et al., 2012). Authorities or leader of the healthcare organization should envision the process and effect of implemented change so that the loopholes and resistance of employee can be minimized on the priority basis. Finally, the authorities should implement the change in an orderly manner so that management and transition to the newer process can be done effectively. Further for the enthusiasm of the change agents, the management should arrange rewards and recognition so that outstanding efforts of the nurses and other healthcare professionals to adapt to the change can be recognized (Cummings, Bridgman & Brown, 2016).
Medication error is an important aspect in this evolving healthcare system, and according to the Journal of Nursing Administration, this leads to unavoidable situations, if not avoided and replaced with some other process (Cheragi et al., 2013). To identify the replacing process and minimize the medicational errors, Oshashi et al. (2014) conducted a systematic review and searched 32 articles and found that barcode medication administration has been used to effectively minimize the risk of medication error in all those research articles. The prime reason for errors identified in those articles was impaired cognitive skills of the nursing profession because they had to handle more than 50 patients’ every day (Bonkowski et al., 2013). Therefore, implementing barcodes in the administration process will help them to remind the last dose of drug administration to a specific patient. Further, as per Rack, Dudjak & EWolf (2012), as the shift of a specific nurse is fixed, the other nurse who replaces the first one is unable to understand the drug administration process and leads to medication error. Therefore, to restrict the medication error, usage of barcode medication administration system should be implemented as a changed process in the healthcare organization in the discussion.
Conclusion
While concluding the assignment it should be mentioned that change is spontaneous and to attain a sustainable development in every aspect, each organization should undergo a change management process. While, unable to change with the advanced system, the organization, its employees are unable to provide its customers with effective and quality service. The role of leaders and innovative ideas are important in this case as leaders holding the hand of employees and direct them to the desired success determined by them for the organization. Further, innovation is the process through which, newer ideas and substances are introduced into the company that helps in the expansion or improvement of the process. In combination, leaders with their innovative ideas implement change in the organization, and the change agents’ help to drive the change in the desired direction. In this assignment, the proposed change was the implementation of Barcode Medication Administration (BCMA) in the renal department of the healthcare organization, the situational or contingency theory of leadership was implemented and Kurt Lewin change management theory was implemented in the process. Furthermore, in the assignment, the SWOT analysis of the working environment in driving the process was carried out and the benefit of the Lewin change management in driving the change was described in the process with a proper discussion about the proposed change and its benefit in lowering the error related to medication.
Types of Innovations in Healthcare
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