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Leadership Style and Patient Safety

Leadership Style and Patient Safety

Patient safety requires that the quality and safety of care provided to the patient is upheld through the reduction, prevention, analysis, and reporting of medical or any other errors within the health care environment that are likely to cause harm to the patient[ CITATION McF15 l 1033 ]. Different health care organizations have put in place different mechanisms to promote patient care, ranging from safety policies to defined procedures that set the standards of practice. Nevertheless, it remains critical that leadership plays an integral role in facilitating proper patient care and collaborative practice among the health care providers, leadership refers to the multifaceted approach to the identification of a target or a goal, motivating other persons towards achieving the goal, and providing the necessary motivation and support required to achieve the identified goal. For nurses, this could involve the proper coordination of the shifts and facilitating team work among the nurses to achieve the best patient outcomes[ CITATION McF15 l 1033 ]. The leadership skills of the nurse leader are hence critical in facilitating successful shift operations, managing staff morale and challenging or difficult situations. Such skills are defined by the leadership style in effect. As such, this paper will review the transformational, transactional, and laissez-faire leadership to determine their impact on patient safety within the health care environment.

There are various leadership styles that are adopted by individuals in the senior positions at the workplace based on which the employee behavioral model is shaped to allow for the achievement of goals. One of the leadership styles that are discussed in this paper is transformational leadership. This is a type of leadership in which the behavior of the leader is emulated by the employees and hence it inspires and transforms them, allowing them to transcend self-interest and perform more than expected for the greater good of the organization[ CITATION Won13 l 1033 ]. The four elements of this type of leadership include inspirational motivation, charisma or ideal influence, individualized consideration, and intellectual stimulation. In this case, inspirational motivation refers to the leader providing his or her followers with a vision and facilitating increased performance[ CITATION Won13 l 1033 ]. Individualized consideration involves the level of concern that the leader shows for the skills and needs of their respective followers. Intellectual stimulation, on the other hand, refers to the manner in which a leader replaces traditions, beliefs, and old assumptions with logic and novel thoughts[ CITATION Won13 l 1033 ]. Last but not least, ideal influence refers to the morals and values emphasized and observed by the leader[ CITATION Won13 l 1033 ].

The second leadership style under consideration is transactional leadership, which refers to leadership that allows the leader to facilitate compliance with the set processes and systems, via the application of punishments and rewards[ CITATION Cla13 l 1033 ]. This type of leadership is focused on group performance, organization, and the role of supervision. As such, the employee’s work is scrutinized and followed by the leader to identify any deviations or faults. This style forms a highly effective approach to the management of emergency and crisis situations, and in cases where there is need to perform a given task in a specific, predetermined fashion[ CITATION Cla13 l 1033 ]. The third leadership style under review is the Laissez-Faire leadership, which involves little or no governance or direction being provided by the leader, and instead of a hands-off approach being embraced[ CITATION Fis16 l 1033 ]. With this type of leadership, the rate of decision-making is low, there is no proactive quality improvement, and changes only occur once in a while. In most cases, this leadership approach is embraced by individuals whose careers are almost ending since they know they are about to be replaced, or those who are new and inexperienced[ CITATION Fis16 l 1033 ].

One of the primary goals in healthcare is to facilitate increased patient quality of care that may be achieved via effective nurse leadership. Effective leaders encourage their subordinates to establish a proper relationship with the patients, allowing them to understand their values and needs[ CITATION Mer15 l 1033 ]. Such strategies result in improved nurse-patient relationships, patient satisfaction, and reduced recovery time. Nurses who are empowered develop eagerness towards implementing evidence-based practice. Such nurses demonstrate high levels of motivation, increased commitment to the goals of the organization, and expanded knowledge on patient management, hence effective patient care[ CITATION Mer15 l 1033 ]. Better patient outcomes can be achieved through proper leadership by facilitating increased competence and an increased ability of the staff. Effective leadership allows nurses to attain the required motivation to observe maximum standards and approaches directed at facilitating positive patient outcomes. Proper leadership also allows for the proper identification of the distinct motivators of the nurses and establishment of approaches through which such nurses can be motivated towards delivering their best services, hence increasing patient safety[ CITATION Won13 l 1033 ]. By increasing nurses’ commitment towards patient care, effective leadership allows for the timely assessment and identification of patient needs and hence initiating appropriate care approaches required to alleviate any situations that would result in patient harm. Last but not least, effective leadership allows for increased team work and collaboration among the health care professionals, hence encouraging an increased sense of responsibility and reducing chances of errors in patient care[ CITATION McF15 l 1033 ].

According to Merrill (2015), transformational leadership forms the best leadership style that can be embraced in a health care system as the leaders are proactive. In this case, transformational leaders would allow for the identification establishment of a safety culture that would allow for increased caution and sensitivity when handling the patients. Transformational leaders promote socialization within the health care environment[ CITATION Mer15 l 1033 ]. This is important as it allows the newly recruited nurses to learn both the skills and knowledge necessary for them to facilitate patient safety and the nursing culture within the department. In addition, transformational leaders create a blameless system that allows the nurses to review errors as a team and embrace them as opportunities to learn, as opposed to incompetence[ CITATION Mer15 l 1033 ]. This style of leadership would be more effective in the wards as it offers longevity.

Transactional leadership, on the other hand, tends to be short-lived, task-based, and episodic[ CITATION Cla13 l 1033 ]. In a hospital setting, this type of leadership proves to be highly effective in situations that require strict following of provided rules and regulations. This leadership style would allow for the embracement of approaches that are situation specific and for proper adherence to the guidelines, which is critical for the safety of the patient, identifying any errors that are likely to threaten the life of the patient[ CITATION Cla13 l 1033 ]. Nevertheless, this approach is less likely to be effective in units that demand longevity such as the wards as it is associated with reduced motivation for the employees in the long-term and may result in increased nurse turnover[ CITATION Cla13 l 1033 ].

The laissez-faire leadership style is less effective in a health care setting as it creates a blameful environment, with the leader failing to make decisions, hence creating animosity and reduced collaboration among the nurses, an aspect that results in increased chances of medical errors[ CITATION Mer15 l 1033 ]. In addition, these type of leaders fail to proactively respond to issues of importance to the safety of the patients and only react to negative outcomes, hence exposing patients to increased risk of harm[ CITATION Mer15 l 1033 ]. For example, a laissez-faire leader may fail to respond to the need to increase the number of nurses to reduce the ratio between nurses and patients, an aspect that results in increased nurse fatigue and ineffectiveness in handling the needs of the patients.


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McFadden, K. L., Stock, G. N., & Gowen III, C. R. (2015). Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety. Health Care Management Review, 40 (1), 24-34.

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