Leadership and Management Essay

The implementation of the tending of the dying constitution at the generators area of practice involved the process of diverge. This involved the intake of twain attractership and caution theories which are essential to increased long suit as support by Moiden (2002). The convince was a political unity due to the establishment initiatives to improve end of life care (Department of wellness 2008). Antrobus (2003) states that political leaders aim to deliver improved health care outcomes for patients. The essay will unfavorablely analyze both leadership and management theories from the top of the organization to the bottom. These theories were apply to implement this tack to enhance character reference care in this clinical area. The essay will also critically analyze and evaluate the nurses self management skills in fulfilling their role as clinical music directors within interdisciplinary and the changing context of the healthcare.Similarly, the essay will discuss t he implications upon quality assurance and resource allocation for service slant within the health care sector. These will be related to contemporary government strategies. The effects of government strategies in involving the user and carer or of import others in decision making process within current clinical and legal frameworks (Department of Health 2000b) will also be palisaded. Similar debate will also be on the nurses involvement in polity making (Antrobus 2003). Further discussion on government strategies will be discussed on the introduction of clinical governance and essence of care. Braine (2006) states that the purpose of implementing change is to improve rough-and-readyness and quality. The whole process of change was found on the introduction of the care of the dying booklet which meant that all healthcare schoolmaster documented their nones in the same booklet.The change took in want in a large hospital to implement a new policy which was politically driven by the government to improve quality of care. Like closely hospital organizations, the hospital tralatitiously uses a bureaucratic management advent ( marquis and Huston 2006) reinforced with authoritarian leadership to promote efficiency and cost effective care. This is done through planning, coordination, control of services, putting appropriate structures and trunks in adjust and monitoring progress to protects performance activities (Finkelman 2006 and Faugier and Woolnough 2002). According to Marquis and Huston (2006) bureaucracy was introduced subsequently Max Webers work to legalize and make rules and regulations for force play to increase efficiency.The ward manager as a change means had to design and plan the process of change. Designing change involved apprehension the purpose of change and gathering data as supported by Glower (2002). final causening included identifying driving forces and modes to reduce restraining forces (Glower 2002). un give care the top management who used bureaucratic management opening, the ward manager employ the benignant traffic management conjecture (Marquis and Huston 2006) at ward level. This management opening is designed to motivate employees to accomplish excellence.The human relations guess 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 demandal theory, Lezon (2002) agrees that this theory views the employee in a diametric appearance and helps to understand sight violate 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 mint need to work, are responsible for(p) and self motivated, they want to succeed and they understand their locate in the organization. perhaps the appropriateness of this theory can be think to the implem entation of clinical governance which emphasizes that it is the responsibility of health care professed(prenominal)s to fit force, high standards and quality (Braine 2006).This puts health care professionals in a responsible position and motivates them to provide high quality care. This explains why theory Y was used as opposed to theory X which according to Lezon (2002) assumes that people are lazy, unmotivated and require discipline. According to the human relations theory, at that place are some positive management actions that lead to employee penury then improving performance (Marquis and Huston 2000). Some of these actions used by the change component were empowering and allowing employees to make independent decisions as they could handle, training and underdeveloped, increasing freedom, sharing big(a) picture objectives, treating employees as if work is natural and other ways of cause mental faculty as supported by Marquis and Huston (2006 and Lezon 2002).The use of human relations theory in the implementation of this policy is well justify in contrast to other management theories. For example, theory X presumes that people must be coerced, controlled, directed and threatened with retaliatement (Lezon 2002). This theory adds that an fair(a) person has inherent dis worry of work and prefers to avoid responsibility (Marquis and Huston 2006). In other words, theory X prefers autocratic course plot theory Y prefers participative modal value. Managers using theory y seek to enhance the employees capacity to exercise high levels of imagination, ingenuity and creativity solving organisational problems. With the human relations theory, members feel special and involved rather than be controlled by threats and sanctions from the change promoter (Dowding and Barr 2002).The team of health care professionals was aiming to achieve the same goal. This goal was to provide high quality care to patients come end of life. This involved a lot of organiz ational psychology and motivation to facilitate effective teamwork. Among the factors that facilitate effective teamwork, leadership is the close world-shaking as stated by Clegg (2000). Toofany (2005) supports that leadership is on governments modernization agenda for the National Health Service and is an influencing factor. Therefore, the change promoter needed as effective leadership style. To facilitate this, she use 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 based on power of organizational position and authority to reward and punish performance (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 locomote 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 White 2002). By shake a shared 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) value vision as a very Copernican ingredient of transformational leadership, adding that it should be engaging and inspiring.Transformational leadership was first put forward by pile Burns (1978) cited in Marquis and Huston (2006). According to him, a relationship of coarse stimulation and elevation converts followers into leaders, a fact shared by Murphy (2005). If a leader can stimulate followers, he or she can engage followers into a problem solving military position (McGuire and Ke nnerly 2006). In addition, people engage together in a way that allows leaders and followers to raise each other to higher levels of motivation and morality (Marquis and Huston 2006). This woo emphasizes on the leaders ability to motivate, groom and empower the followers rather than control their behaviors (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 commitment is gained on the basis of step in of reward, pay and security in return of reliable work (Mullins 2002). moreover McGuire and Kennerly (2006) state that if transactional leadership is predominantly used, followers are likely to place limits to organizational commitment and behave in a way altogether aimed at contract requirements. Despite the differences in various leadership styles, most researchers conclude that in that locatio n is no one leadership style that is fifty-fifty off for all circumstances (Reynolds and Rogers 2003). Fidler (1967) cited in Moiden (2002) agrees that a single leadership style is rarely practiced. Therefore situational theories were introduced in articulate to deal with various situations.Perhaps this is why the leader used the situational approach to leadership in order to meet the demands of different situations, an idea also shared by Marquis and Huston (2000). Reynolds and Rogers (2003) suggest that the effectiveness of day to day activities depends on balancing mingled with 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 situational approach was used in conjunction with transformational leadership style. Reynolds and Rogers (2003) support that situations like this require the leader to vary their style. However, they warn that it is important 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 strength 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(prenominal) on interpersonal factors. Support was given to followers according their needs. supportive 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 communication system which involved listening, praising, asking 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. Rey nolds and Rogers (2003) support that the style of leadership alters as performance improves from directive to coaching to supporting to delegation. Basing on research studies, Reynolds and Rogers (2003) warns that using different approaches to different staff can practically difficult in terms 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 relevancy of situational approach to this clinical area. The delegation was directed to some members of the team age others still wanted to be directed. In addition, this was because of the leaders trust in people, operative to their strength and sharing the vision as supported by Kane-Urrabazo (2006). Delegation is defined as transferring responsibility of an activity to some other individual and still remain accountable (Sullivan and Decker 2005).David son et al (1999) caution that critical thinking and sound decision making must be applied before delegating because it increases rather than decrease nurses responsibility. They clarify that to ensure natural rubber outcome, delegation must be the flop task, right circumstances, right person, right instructions 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 experience while remembering that you remain accountable. However, Kane-Urrabazo (2006) and Taylor (2007) argue that delegation is another way of empowering the subordinates.However, like every team going through the process of change, problems arose and were solved as they came. Apart from dealing with problems like resistance and lack of resources, there was an even bigger problem of interdisciplinary working 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 pathway.Whether inside or outside health care, interdisciplinary working was introduced with the same concerns of improving quality (Hewison 2004). Interdisciplinary working has been emphatic 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 lot of emphasis on professional education and training. Effective interdisciplinary working is meant to facilitate delivery of quality services and is fundamental to victory of clinical governance (Braine 2006). However, Hewison (2004) argues that there is little try to support the effectiveness of interdisciplinary working. There is also insufficient evidence to support that collaborationism improves quality of care given to patients (Hewison 2004).Nevertheless, if interdisciplina ry working is to be achieved it is important to appreciate the potential 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 often averse 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 lyric can contribute to professional barriers, mistrust, misunderstanding and disagreements (Hewison 2004). To solve this problem the change agent and senior 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 future 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 government antecedency (Hewison 2004). Therefore study programmes for health care professionals are important to facilitate this approach to learning.