Patient safety – Case study:

Patient safety is an aspect of health management practice that implements safety science methods in the direction of attaining goal of reliable method of health care delivery. Patient safety also incorporates actions towards minimizing the impact of undesirable conditions and recovery from these conditions. Patient safety is central goal of the health care organization and leadership plays a significant role in the in achieving this goal. Leadership can enhance or maintain patient safety through both the ways, by giving practical training to the subordinates about the healthcare practice and through enhancing the interest and knowledge of the subordinates about the patient safety. Leader in the healthcare system has a prominent role in patient safety because healthcare system functions based on the integrated service of different stakeholders like nurse, ward boy and pharmacist. Each and every stakeholder has important contribution in the patient safety and good leadership can facilitate coordinated functioning of the unit to achieve goal of patient safety. In healthcare services each patient needs to be handled differently based on the severity of the disease, social, cultural and economic background of the patient. Hence, there are the different structures of practices and methods for each patient both in terms of medical and psychological wellbeing of the patient. Leader plays fundamental role in deciding these practices through experience and evidences available (Scully, 2015). Communication with the patient and family members of the patient is very important in healthcare. This is required for convincing patient and family members about the medical practice to be implemented and to boost their moral (Negussie and Demissie, 2013). Only leader can perform this function because patient and family members can have more faith on leader as compared the other stakeholders. Leader is the backbone of the healthcare system and can handle patient safety very effectively in all types of situations.

Introduction:

Leadership is the vital aspect in a successful patient safety program. Only leaders can effectively guide efforts in their health care organizations to promote the practice and dedication necessary to address the essential medical practice errors and harm to patients. A leader’s role is to bring out efficient practice from subordinates. This incorporates leading and influencing the establishment of principles, idea and prospect to improve goal of patient safety.  The exclusive function of leadership is to implement the value system, plan strategic goals, support efforts, make available resources, eliminate obstacles and follow established and acceptable practices. In this essay, implementation of leadership in patient safety in discussed (Carroll, 2005).

Leadership Training:

Leadership training helps leaders to improve productivity of the group by effectively using emotional intelligence to allow subordinates to perform in both usual and adverse conditions. Leadership training helps leaders to retain subordinates for long term so that there is increase in the productivity. Leadership training helps leaders to encourage subordinates to take future leadership. This strategic and succession planning help leaders to retain employees. Leadership training helps to improve employee engagement by giving regular feedback to the subordinates. There are different leadership styles and theories are available. Leadership training helps to implement appropriate leadership theory according to the needs of the organization and capability of the subordinates. Leadership training helps leaders to make proper decisions based on the emotional intelligence and business intelligence for the benefit of the organization and employees (Hemman, 2000; Murray et al., 1998).

Leadership theories:

Three leadership styles identified which can play significant role in the productive and smooth functioning of patient safety and healthcare management. These are Transformational leadership, Democratic leadership and Authorization or Autocratic leadership.

Transformational leader : Transformational leadership is mainly depend on building positive association among all the stakeholders of healthcare management like clinicians, nurses, ward boy and pharmacist. In this leadership style, leader should motivate other subordinates by demonstrating them with vision and mission to accomplish patient safety. Leaders in this style are role models for other subordinates both in terms of actual practice and communication. The leader, mainly doctor in this leadership style is well versed with all the procedures and practices related to patient safety. Also, doctor teaches all the procedures and practices to other subordinate in a very convincing and friendly manner. While teaching all these procedures and practices related to patient safety, Doctor seeks opinion of the subordinates about the teaching method and modifies or amends according to the subordinates understanding capability. Subordinates also feel important part of the process of patient safety with this method of teaching. This helps to develop more responsive nature in the subordinates and encouragement to learn new and challenging practices of patient safety (Wong et al., 2013). In this leadership style, leader encourages subordinates to take new challenges by allocating different type of patients and monitoring the practice of subordinates in managing the patient. By virtue of this leadership all the stakeholders get benefited. Leaders build trust and confidence on the subordinate in managing patient safety, subordinates get the confidence and new learning for patient safety and most importantly patient get quality services and overall improvement in the patient condition. Transformational leaders give encouragement to subordinates for their good performance by praising their work and giving example of the work to other subordinates. So that, other subordinates also get stimulus to work better. Transformational leader helps to subordinates in performing healthcare practices, which are new to subordinates or the practices or method which these subordinates can’t perform on their own. This helps to build a relation of trust and loyalty between transformational leaders and subordinates (Dunham-Taylor, 2000).

Democratic leader: Principle of working of democratic leader is participation of each stakeholder in both actual practices and decision making of the healthcare services offered for the patient safety. Democratic leader achieve this by effective communication with all the stakeholders of healthcare management. Democratic leader always welcome the decisions taken by subordinates, if these decisions are adding value to the services and practices of patient care. Democratic leader has the qualities of listening to decisions and opinions of the subordinates, recognizing subordinates endeavor, decision making to make appropriate decision on subordinate’s decisions. Democratic leader also has the understanding of the current and appropriate practices of patient care to implement subordinates decisions. Democratic leader gives sense of responsibility to subordinates so that there is more focused practice by subordinates and better care of the patient to improve overall care practice of the patient (Finkelman, 2012). Democratic leader maintain the accountability of the stakeholders. By keeping accountability, democratic leader can rank subordinates based on their competence and efficiency. Democratic leader seek feedback about the performance of the subordinate from the subordinate and other stakeholders of the group. This helps democratic leader in making proper allocation of the subordinates to the patients, based on the patient condition and type of the intervention requirement by the patient. Practice of handling responsible tasks by the subordinates, lessen the stress and work pressure on the leader and so that leader can direct more focus towards more critical patients and overall outcome of the patient safety and well-being can be achieved effectively. In case of inadvertent error by the subordinate, transformational leader help in correcting it and instead of discouraging the subordinate for mistake, leader motivate subordinate to learn from this mistake and improve upon it. Democratic leaders have less control on their subordinates because they give suggestions to the subordinates rather than ordering about the practice to be implemented. This leadership is more useful while working with the subordinates with sound theoretical knowledge and technically well versed in practice to be implemented (Boyle and Kochinda, 2004).

Autocratic leader: Autocratic leadership is different from the transformational and democratic leadership. Unlike, transformational and democratic leadership, this leadership is more controlling nature, power-oriented and inflexible to each and every stakeholder. Autocratic leaders believe more in obedience, faithfulness and following rules strictly. All the subordinates may not like this type of leadership qualities, however at the completion of whole process, its whole outcome is positive, there is great appreciation of the of leader for his way of handling the team. Although, autocratic leaders are out of favor for subordinate, it is proved that these subordinates work often more productively under autocratic leaders. One prominent drawback of the autocratic leadership is that some important information is withheld from the subordinate and this lead to lack of trust among the all the stakeholders. As a result, even though productivity in work is more in autocratic leadership, due to lack of proper understanding and positive communication, holistic management of the patient safety can be affected (Giltinane, 2013). Micromanagement by the autocratic leader can lead to the division within the team and it affects communication among the team related to patient and high possibility of error in the procedure to be implemented for the safety and cure of the patient. This type of leadership can be more effective in emergency situations because subordinate work effectively according to the orders given and in emergency conditions there is little time of discussions about the patient. Autocratic leaders are well planned in patient care and they are more precise about procedures to be carried out for the management of the patient. Autocratic leaders are very straightforward in their actions by appreciating subordinates with good performance and punishing subordinates with poor performance. Subordinates working with the autocratic leaders are completely dependent on the leader and it can prove to be less productive in the absence of leader. However, all the stakeholders in the patient care should take responsibility of patient care and in such scenario leader can feel stress due to underperformance of subordinates (Künzle et al., 2010).

Critical Analysis:

As transformational leadership is mainly based on the cohesive working of the team, this type of leadership can work very effectively to avoid medication error because there is very good communication among all the stakeholders. Transformational leadership also play important role in reducing sickness of patient and improving moral boost of the patient and patient family members. As transformational leadership is mainly based on the coordination and cooperation among all the stakeholders including patients, this leadership is more useful in preventing fall of the elderly patient (Jefferson, 2014). Democratic leaders have less control on their subordinates because they give suggestions to the subordinates rather than ordering about the practice to be implemented. This leadership is less useful while working with the subordinates with little theoretical knowledge and technically well versed in practice to be implemented like in ICU conditions (Merrill, 2015). Autocratic leadership can be more effective in emergency situations because subordinate work effectively according to the orders given and in emergency conditions there is little time of discussions about the patient. In autocratic leadership, autocratic leader feel more pressure and subordinate feel less pressure (Giltinane, 2013).

Conclusion:

Three types of leadership like transformational leadership, democratic leadership and authorization or autocratic leadership are discussed. There is overlap between transformational and democratic leadership in few of characteristics. However, autocratic leadership is completely contrasted in characteristics and application as compared to transformational and democratic leadership. In transformational leadership main focus is on cohesiveness in team for patient safety, in democratic leadership opinion of all the subordinates is considered for decision making of patient safety and autocratic leadership functions mainly according to direction and orders of the leader. Transformational and democratic leaderships are applicable in situations where more discussions are required like handling elderly patients and autocratic leadership is more applicable in situations like emergency case where no discussion is required and action should be taken under leaders order. These all type leadership is useful in achieving goal of patient safety depending on the condition of the patient.