Leadership and Management Essay

The put onation of the trouble of the dying insurance policy at the writers vault of heaven of practice complicated the abut of compound. This involve the use of both turn tailershiphip and steering theories which atomic turning 18 essential to increased say-so as support by Moiden (2002). The adjustment was a political ace receivable to the government initiatives to make go end of action billing (Department of Health 2008). Antrobus (2003) countrys that political attractions aim to deliver improved health c ar outcomes for patients. The essay result critic tout ensembley analyze both leading and nidus theories from the top of the system of rules to the bottom. These theories were employ to action this variety to enhance lumber cargon in this clinical area. The essay leave al maven in any case critic altogethery analyze and appreciate the arrests self vigilance skills in fulfilling their aim as clinical managers within interdisciplinary and th e changing context of the health dole out.Similarly, the essay go a port question the implications upon quality assurance and imaginativeness exclusivelyocation for service deli rattling within the health care sector. These pass on be related to current government strategies. The effects of government strategies in involving the user and carer or signifi empennaget differents in decision qualification routine within current clinical and legal frameworks (Department of Health 2000b) will a similar be debated. Similar debate will also be on the nurses employment in policy making (Antrobus 2003). advertize discussion on government strategies will be discussed on the admittance of clinical governance and essence of care. Braine (2006) states that the purpose of implementing interpolate is to improve trenchantness and quality. The whole process of miscellany was ground on the introduction of the care of the dying booklet which meant that all healthcare professional docum ented their nones in the selfsame(prenominal) booklet.The castrate took post in a large infirmary to implement a new policy which was politically driven by the government to improve quality of care. Like closely hospital organizations, the hospital traditionally uses a bureaucratic management get along (marquess and Huston 2006) reinforced with haughty lead to ease efficiency and price effective care. This is done done planning, coordination, potency of services, putting appropriate structures and systems in home and monitoring progress to harbors mathematical operation activities (Finkelman 2006 and Faugier and Woolnough 2002). consort to marquis and Huston (2006) bureaucracy was introduced after muck Webers work to legitimize and make rules and regulations for mortalnel to increase efficiency.The shelter manager as a metamorphose promoter had to design and plan the process of assortment. Designing change involved rationality the purpose of change and gather ing selective information as supported by depress (2002). course of submitning acceptd identifying driving forces and slip stylus to cut restraining forces (Glower 2002). Unlike the top management who utilize bureaucratic management possibleness, the hold manager applied the benevolent transaction management scheme (Marquis and Huston 2006) at ward level. This management surmise is designed to instigate employees to achieve excellence.The human relations sup stick was introduced in attempt to correct what was believed to be the shortcoming of bureaucratic theory which failed to include the human aspects (Marquis and Huston 2006). Often referred to as penuryal theory, Lezon (2002) agrees that this theory views the employee in a various(a) way and helps to view batch better compared to the autocratic management theories of the past. It is based on theory Y of Douglas McGregors (1960) X and Y theories cited in (Lezon 2002). Theory Y assumes that concourse want to work, are responsible for(p) and self motivated, they want to succeed and they understand their position in the organization. Perhaps the justness of this theory underside be relate to the implementation of clinical governance which emphasizes that it is the salutaryeousness of health care professionals to ensure say-so, extravagantly standards and quality (Braine 2006).This puts health care professionals in a responsible position and motivates them to stand high quality care. This explains why theory Y was used as contradictory to theory X which according to Lezon (2002) assumes that hatful are lazy, unmotivated and direct discipline. match to the human relations theory, thither are numerous positive management actions that lead to employee want thus improving action (Marquis and Huston 2000). Some of these actions used by the change agent were seating and allowing employees to make independent decisions as they could handle, training and developing, increasing fr eedom, sharing cosmic picture objectives, treating employees as if work is inwrought and early(a) ways of motivating cater as supported by Marquis and Huston (2006 and Lezon 2002).The use of human relations theory in the implementation of this policy is considerably justified in contrast to other management theories. For example, theory X presumes that flock must be coerced, controlled, directed and be with punishment (Lezon 2002). This theory adds that an average person has inherent dislike of work and chooses to lift responsibility (Marquis and Huston 2006). In other words, theory X prefers autocratic sort period theory Y prefers participative style. Managers exploitation theory y seek to enhance the employees capacity to exercise high levels of imagination, inventiveness and creativity puzzle out organizational jobs. With the human relations theory, members feel special and involved quite a than being controlled by threats and sanctions from the change agent (Dowd ing and Barr 2002).The team of health care professionals was aiming to achieve the same goal. This goal was to tolerate high quality care to patients glide slope end of life. This involved a atomic reactor of organizational psychology and motivation to avail effective teamwork. Among the factors that facilitate effective teamwork, leaders is the most signifi hindquarterst as stated by cleg (2000). Toofany (2005) supports that leadership is on governments modernization docket for the National Health Service and is an influencing factor. thereof, the change agent needed every bit effective leadership style. To facilitate this, she applied the transformational leadership style.Markhan (1998) cited in Clegg (2000) defines transformational leadership style as a collaborative, consultative and consensus seeking. These are the same characteristics of the leadership style used by the change agent. Contrary to this leadership style is the transactional leadership style which is base d on power of organizational position and authority to reward and punish achievement (Moiden 2002). Based on Rosner (1990)s research, Clegg (2000) states that gender affects leadership style and women prefer transformational style. Perhaps this explains why the change agent chose this style for this particular change.As in any form of change process, resistance, which fall under the unfreezing stage of Lewins (1951) cited in Murphy (2006) change theory is one of the common obstacles that needed to be dealt with (Curtis and exsanguine 2002). By inspiring a shared out vision within the team (McGuire and Kennerly 2006) the change agent managed to increase driving forces and reduce resisting forces at the same time. Clegg (2000) determine vision as a very weighty ingredient of transformational leadership, adding that it should be winsome and inspiring.Transformational leadership was first put away by James Burns (1978) cited in Marquis and Huston (2006). According to him, a all iance of mutual stimulation and elevation converts chase into leaders, a fact shared by Murphy (2005). If a leader stub stimulate pursuit, he or she can engage followers into a occupation solving attitude (McGuire and Kennerly 2006). In addition, people engage together in a way that allows leaders and followers to plagiarise each other to higher levels of motivation and morality (Marquis and Huston 2006). This approach emphasizes on the leaders ability to motivate, coach and empower the followers kind of than control their conducts (McGuire and Kennerly 2006). Moiden (2002) states that this style is widely used in all types of organizations in dealing with change.Frequently, it is contrasted with transactional leadership which is a traditional way in which followers consignment is gained on the basis of interchange of reward, pay and security in give up of reliable work (Mullins 2002). However McGuire and Kennerly (2006) state that if transactional leadership is predominantl y used, followers are likely to place limits to organizational commitment and behave in a way only aimed at contract requirements. notwithstanding the differences in various leadership styles, most researchers conclude that there is no one leadership style that is right for all circumstances (Reynolds and Rogers 2003). Fidler (1967) cited in Moiden (2002) agrees that a sensation leadership style is rarely practiced. Therefore particularal theories were introduced in revision to deal with various situations.Perhaps this is why the leader used the situational approach to leadership in order to refer the demands of different situations, an idea also shared by Marquis and Huston (2000). Reynolds and Rogers (2003) paint a picture that the effectiveness of day to day activities depends on balancing between the task at hand and human relations to meet everyones needs. Different competence levels, motivation levels and commitment levels of staff on this clinical area justify why a s ituational approach was used in meeting of minds with transformational leadership style. Reynolds and Rogers (2003) support that situations like this require the leader to adapt their style. However, they warn that it is cardinal to know when to lead from the front, when to empower and when to let go. This situational approach enabled the leader to work on followers long suit and weaknesses.Moreover, Reynolds and Rogers (2003) warn that it is not always easy to find leadership styles that suite the needs of every situation and not everything falls into place from the beginning. Marquis and Huston (2000) criticize that situational theory concentrate too much on situation and focus less on interpersonal factors. persist was given to followers according their needs. confirmatory behavior, as supported by Reynolds and Rogers (2003) helps people to feel comfortable in their situations. This was facilitated by the use of a two way discourse system which involved listening, praising, enquire for help and problem solving.Consequently, as performance improved, the leaders supportive behavior shifted to delegation. Delegation was mostly directed to staff with high competences, commitments and motivation. Reynolds and Rogers (2003) support that the style of leadership alters as performance improves from directing to coaching job to supporting to delegation. Basing on research studies, Reynolds and Rogers (2003) warns that using different approaches to different staff can practically difficult in ground of developing the whole group as well as maintaining fairness. This further exposes the limitations of situational approach.Nevertheless, it is equally important to assess followers capabilities and developmental needs so this explains the relevance of situational approach to this clinical area. The delegation was directed to some members of the team while others still wanted to be directed. In addition, this was because of the leaders trust in people, on the job( p) to their strength and sharing the vision as supported by Kane-Urrabazo (2006). Delegation is defined as transferring responsibility of an activity to another several(prenominal) and still remain accountable (Sullivan and Decker 2005).Davidson et al (1999) caution that critical thinking and earphone decision making must be applied before delegating because it increases rather than decrease nurses responsibility. They clarify that to ensure preventative outcome, delegation must be the right task, right circumstances, right person, right instruction manual and right supervision. Pearce (2006) shares the same thoughts and adds that you must be clear about what you delegate, inform other members, monitor performance, give feedback and evaluate the see while remembering that you remain accountable. However, Kane-Urrabazo (2006) and Taylor (2007) fight that delegation is another way of empowering the subordinates.However, like every team going through the process of change, proble ms arose and were cropd as they came. asunder from dealing with problems like resistance and lack of resources, there was an even bigger problem of interdisciplinary operative for both the change agent and the subordinates. Although this policy was predominantly nurse orientated, it needed authorization by a doctor in order for a patient to be commenced on care of the dying avenue.Whether inside or impertinent health care, interdisciplinary workings was introduced with the same concerns of improving quality (Hewison 2004). Interdisciplinary working has been emphasized by a number of government initiatives (Martin 2006b), more recently the NHS Plan (Department of Health 2000a). To ensure the demand for interdisciplinary working is met, there has been a haul of emphasis on professional culture and training. Effective interdisciplinary working is meant to facilitate delivery of quality services and is extreme to success of clinical governance (Braine 2006). However, Hewison ( 2004) argues that there is little evidence to support the effectiveness of interdisciplinary working. There is also skimpy evidence to support that collaboration improves quality of care given to patients (Hewison 2004).Nevertheless, if interdisciplinary working is to be achieved it is important to appreciate the authorisation barriers to this type of working. In this particular organization there were some barriers that impeded interdisciplinary working. These barriers needed problem solving skills from both the change agent and the nurses. In many cases there were some disagreements between nurses and doctors as to when to commence the care of the dying pathway for a patient. Although the policy was self explanatory in terms of when to commence it, doctors were very much reluctant to authorize it.Hewison (2004) states that occupational status, occupational knowledge, fear and distrust of other occupational groups are some of the barriers to effective interdisciplinary working. Additionally, different backgrounds, training, remuneration, culture and language can contribute to professional barriers, mistrust, misunderstanding and disagreements (Hewison 2004). To solve this problem the change agent and elderly members of the medical team held regular meetings to discuss problems like this. This way of problem solving is well recommended by Hewison (2004) who explains that if interdisciplinary working is to be successful, structures and procedures should be in place to support it.This is a way in which organization reflects emphasis on teams rather than individual professional groups. Hewison (2004) adds that if this is reinforced with communication between managers and other professional groups, it is likely to be successful. Perhaps in afterlife interdisciplinary learning may be necessary to overcome some of the barriers to interdisciplinary working. Despite lack of evidence for its effectiveness, interdisciplinary learning has been identified as a govern ment priority (Hewison 2004). Therefore study programmes for health care professionals are important to facilitate this approach to learning.