Challenges In Decision Making For Health Care Leaders In Aged Care And Disability Health Services

Overview of Health Care Management in Australia

Question:

Critically discuss some of the challenges that health care leaders are faced with in terms of decision making within the team environment. Explore this specifically in relation to to the aged care sector and disability health services. Define key areas and the impact of possible specific decisions may have within the functioning of the team. Draw examples from your area of work, create a list of how the process of decision making skills may be improved within your team.

The chapter addresses the growth in heath industry since 1990 is huge in terms of technological, leadership and rise of healthcare centers.  Health care management is professional executive board which will focus on the leadership and directions which will give the health care organisations deliver the best health services within the worldwide.  The chapter will discuss ion the overview on the health care management of Australia (Barr & Dowding, 2008).  Apart from that study will also focus on the roles, responsibilities and functions which are carried out by the health care managers. The discussions will also analyse the key management roles played by the leaders and their functions at different level of the management.  The description of the leadership will give enough scope to understand the current trend in the leadership and various types of activities of the organisations which will explore the challenges that is faced by the leaders in terms of decision making (Graetz et al. 2011).

Problems in interpersonal skills: Difficulties in developing the good working relationship with others. While working in the Manly hospital, in Sydney, challenges to maintain the interpersonal skills with team and with the aged patients which was very tough because of the Muck habits of the patents (Rigolosi & Rigolosi, 2005). However, after identifying the series of attitudes and the behavior of the patients and team member are different from the theoretical approach from the usual hospital. In order to manage the interpersonal skills self awareness, effective listening, questioning and oral communication will give some of assertiveness in order to fight with the existing attitudes of the current members (Gray & Field, 2010). One of the major reason for the poor interpersonal skills is communication process which is because of the lack of interpersonal skills of effective listening, negotiations, persuasion and presentation. 

Difficulty in building and leading team: One of the major difficulty in building team in healthcare because of ego centric people present within the heath care centers. Most of the doctors and the even nurses are very much is sensitive enough. The employee working in the Manly health care centers are very much business schedule so, building team is next to impossible.  On the other hand, as noted by Edmonstone (2011), difficult in selecting and building the team are been some of the major challenges that has been faced by the health care leaders since inception. There has been numerous occasion where the leading employees are given the high importance than the other members.  Building and making the team needs lost of afford for the leader in health care. As the staff members are very Muck in an everyday living. Muck here means to feel discomfort that is arises due to the dealing with the peoples (Gilbert,  2005).   

Roles, Responsibilities and Functions of Health Care Managers

One of the potential problems lies within the leader which defines the critical importance of muck. For instance while working in Manly, Jim and Gloria work together on the day shift , off lately, Jim feels Gloria does not do her part  well, but jims needs up doing most her work.  Jim is feeling bitterness which can be termed as muck   by large (Male & Palaiologou, 2012). However, Jim hides his un-comfortableness with patients but is his attitude shots that, he is very partial distracted. The profession of the doctors and the nurses are being done to the earth but muck is very much arising with the team members even in the best team of the healthcare.  

Failure to meet the business objectives: As discussed by Martin et al. (2012), failure to meet the objectives while delaying with the team shows that failure to meet the objectives.  It is very much difficulties for the leaders to meet up of with the promises and completing the job. As an leaders, it is expected that every leaders much cut be able to perform his/her own work which will again give them enough scope for team to not to perform well. Discomfort within the team can be very much dangerous not matter how much clever is the team lenders, discomfort its disguise. This tends to lose the major objective of the company (Petryshen, 2011).  The major goals of the leaders to achieve the goals of the institution which can be only be achieved by taking care for the communication process and personal touch will reduce the muck.  Failure to meet the objectives is just because of the inefficiency of team functioning.  Due to complexity of health care and limited primary training for providers in the topic areas of the management, leadership and team development, most of the health care centers in Australia need formally grooming providers for executive management and leadership functions (adminpanel.ceda.com.au, 2013).

Narrow functional orientations: This is arises due to the lack of depth to manage work outside the one given current functions are being another major agenda for the issues within the management.  Lack of in-depth within the health care management system creates the rift between the functional areas of the team (Petryshen, 2011). As the team has been assign various woks but managing the job outside one’s given function is been noted as the benchmark assessments which is lacking the functional orientations. Functional orientation helps in a such way that various departments within the health care from the nursing to medicine check up to the extensive research on the diseases. Challenges provides the opportunity to grow and learn for examples, an experience that is new required skills .Health care organisations should look to help employee at each level and across functions in order to understand  the importance of  diversity which is lacking. The health care organisation has not been able to get most out of the employees (www.commonwealthfund.org, 2015).

Avoidable events among aged patients	Aus	NZ	UK
Suicide	112	100	155
Asthma mortality	144	122	100
Measles	187	160	100
Hepatitis B	167	167	168
Smoking rate	111	106	101

With the help of John Adair action centered model, team centered leaders will be deified. Action centered leadership is very much classifies the Adair three circle diagram which illustrates achieving the task, managing the group and the managing the individuals.

Problems with Interpersonal Skills

                                                                           Figure 1: TM John Adair team centered leadership

                                                                                         (Source: Gilbert, 2005, pp-19)

As noted by Goodwin (2006), the action centered leadership is specifically based on the action centered individual model adapts extremely well for the demands of the modern business management. Good manager and leaders are very much has full command of the three main areas of action centered leadership model and should be able to use each of the elements  according to the situations.  Leadership is identified as an essential role within new nursing which will give enough scope to carry on and support the patients and team member which are backbone of the health care centers (Bowerman & Lamb-White, 2007). Some of the major responsibilities of the leaders to achieve the task are given below:

The achievement of goal or task:  This is very much intangible task which is needed to fulfilled at the time of the finishing the task. The major sector defines the clear goals which are shared by the entire members (Barr & Dowding, 2008).

The group of people performing the task: the task of the group will only be able to achieve if the entire member of the group work together. In the health care centers of UK most of the leaders needed to work within the team in order to achieve their target while conduction operation or the conduction any kind of the health assessment (Edmonstone, 2011). The group will have enough scope to work together which will given enough scope to carry out the research.

Individuals members of the group involved in the task: Each of the members will have strong identity and roles to play in the management. The need of people must continue to be met if the group will be able to achieve the goals and wants to remain long term relationship.

2.1Role and responsibilities of the leaders for achieving the task:

In order to identify the aim and visions of the group, the task must be defined which will give enough scope to manage the task which is to achieve the goals.  Apart from that, the leader will also identify the resources, people, systems and tools which will help to gather the team. Besides that creating plan and achieve the task via measuring the timescales and strategy (Graetz et al. 2011). Control and maintain the activities which are needed to be completed within the given time. For instance why working in Australian health centers as leader, the decision making skills while expanding the company will have enough time to monitor the overall performance. 

Difficulty in Building and Leading Teams

2.2 Responsibilities of leadership for team are:

As opined by  Edmonstone (2011), establishing the communication standard within the health care centers will increase the standard of the communications. Setting up soft skills calluses and the style and culture of the health care centers would be higher. Monitoring and maintaining the discipline within the health care is been expected from the employees in order to manage the conflicts (Gray & Field, 2010). The leaders would also have to develop team working, morale and high spirits encourage them towards the objective and aims to manage the overall progress.

2.3 The responsibilities of managers for each individual are:

One of the major responsibilities is to manage the team members as individuals by understanding o personality, skills, strength and weaknesses. Apart from that, leaders should look to resolve the conflicts and sue NO Blaming Policy within the business (Gray & Field, 2010).  In order to develop and utilize the each individuals capabilities and strengths for the achieving the goals leaders must train and develop the individuals to gain the support of the team members.  Leaders need should be professional from the mind and personal from the heart while facing the team problem and advising them which will develop individuals freedom and authority (Edmonstone, 2011).

 Lack of the orientations and lack of training would not give enough scope for the employees to cater large part of the diversified works within the health care sectors (Gilbert,  2005). As a leader, training needs must be given to the entire members irrespective of their performance.  Develop and utilize the each individual’s capability to reach the goals for the health care sectors. John Adair theory of action centered leadership would give valuable elements of management which are different from the conventional for of leadership (Male & Palaiologou, 2012).  The action centered leadership model is best known work by the Adair that is frequently used in developing the individuals.

The leader centered approach is very much has been outdated in the today’s modern world. As for the health care centers, the leaders are very much known to the participative for of leadership which are being considered as the one of the best formula for the contemporary health business.

Leaders centered styles are given below:

3.1 Authoritarian leadership:

It is representing that absolute power is in the hand of the leaders over the followers. Authoritarian leaders are very much into taking the responsibility of identifying organizational goals and strategic path to success with clear expectations (Gilbert, 2005). Authoritarian leader are very much self centered which is very much contradict the thought earlier theory of team based theory of leadership in heath care. Health care centers are very much sensitive place because of the most of people there is very much wounded or the suffering from the diseases (Martin et al. 2012).  An authoritarian leader does not support the team building process rather its only cares about the goals and objectives.

The leaders centered leadership style does not care about the team and its affairs rather it boast of its own power and take decision based on his guts and as per his knowledge.  This type of leadership was used in the 1880’s (Petryshen, 2011). However, it is very well known for managing the conflict within the organisations. However, In spite of many weaknesses, Authoritarian leadership style is still flowed in the military and prison. Moreover, this type of leadership is not going to help the health care sectors as it is one man show rather health care centers are known for the group works to achieve the certain results (Snell & Dickson, 2011).

Failure to Meet Business Objectives

As discussed by  Gray & Field (2010), health care centers in Australia like Manly health care are very much particular about the leadership style which has been practicing within their organizations. As the Authoritarian leadership is not much well suited in the current form a business which is because of lack of the group formations and asset balloons which is used in team building ability that introduces to each other (Rigolosi & Rigolosi, 2005).   The transformation of Australian health care sector since 20^th century was different from the European states. In Europe state agencies, monarchs and parliaments played central character in the establishment of the hospitals. During the time of 1882 to 1990 most of patient who are suffering from the contagious disease are not been admitted within the hospitals because of the obvious reasons of communicating the diseases to others. The leaders were very much particular about the patients that they are visiting as per the wealth and the social status. This style of leadership was followed in older systems which is poor and one man ship (As.wiley.com, 2015).

3.2 Transactional leadership

Transactional form of leadership is another major strategy which is again another of leader centered approach of leadership which is known for orders followers and focus on the goals and the profit rather than on forming the team. Transactional leaders are very  much based on the rewards  for goods performance and the punishment for the failure to do so (Snell & Dickson, 2011)..  It is very much effective in the short term goals rather than long term goals. However, there has been numerous occasions which primarily focus on the completing the task which was applied during the time of 1990-1995 in Manly hospitals. It is not been practiced in the current contemporary business rather today’s leaders are about the taking team along with them in order to achieve the goals of the health care centers (adminpanel.ceda.com.au, 2013).  

Recognizing the problems:  

As a team, each of the members must see and recognize the existing problem and decision should be taken as per the requirements (Snell & Dickson, 2011).  The problems of managing the interpersonal skills with the old age patients which can be seen and building team needs to be addressed as team building stages.

Gathering the information:  With the help of gathering the information about the teams is to verify the problems and develop alternative solutions to the existing problems.

Developing the alternative solutions: In order to develop the solutions accepting the first solutions such as use of NO Blaming policy within the team and building team via  various stages like forming, norming, storming and performing (Gilbert,  2005).   

 Some of the major problems like interpersonal skills, team building, and narrow orientations and not able to meet the objectives:

Skills	Description
Active listening	Paying attention to the conversations and anticipating the ongoing conversations.  Listening to others thoughts and equal opportunity for speaking (Graetz et al. 2011).
Supporting  the ideas	Assuming that others have valid points and point out useful aspects what has been said.  Avoiding the unnecessary comments and criticisms.
Being comfortable in sharing the views	Given importance to the group thinking concern for the teams.  Reason giving for differences within thought process of team and the leaders.
Participating	Each and every team member including the Muck and introverts need to speak of the presumed status in order to maintain the status. Team faces issues which should be address as the problem as team (Edmonstone, 2011).
Implementing the suitable alternative	Choosing the best alternatives like, NO blaming policy rules, Tow way communications and the feed forward  for  examine the proposed plans and actions.
Evaluating	Team buildings is very much a learning process  which is needed to be reviewed with time and again.

                                                   Figure 2: factors influencing physiotherapy decision making in care settings

Narrow Functional Orientations

                                                                                 (Source: Petryshen, 2011, pp-23) 

The decision making is very much influenced by how individuals are taking decisions and creating the exact outcome to achieve the task.  While taking the hypothesis in heath acre practice, here individuals takes the decisions based on the aim of choice and choose the best alternatives (Martin et al. 2012). Decision making within the clinical perspective is very much collaborative process involved in parallel decisions making with the patients and team of the health professionals. While working in Manly health care  in Sydney, the decision making about the individuals patients care is very much complex and dependent process because of involvement of team (Male & Palaiologou, 2012). Some of the major decision making potential capacity to identify and collect the relevant information’s which increases the capability to form a decision and also predict the decisions. Apart from that as a team leader, emotional awareness capabilities  are one of the major capabilities being impacted on the decisions making.  Lastly, social capability to interact with the others and team members would encourage the leader to take effective decisions making autonomy (www.commonwealthfund.org, 2015).

Conclusion

From the above study, it has been found there are three kind of leadership which is very much famous in the health  care centers. In early 1880 authoritarian and transactional leaders are very much old school thought of leader centered approach.  On the other hand , the other leaders  discussed here is team centered leadership approach which define by Adair John action centered leadership. From the theory it has been seen that, everyone including leaders should have major roles and responsibilities to fill in the gap within the team. By giving the examples of Manly hospital in Sydney, it has been found that most of worker is very much lacking the interpersonal skills. Apart from that, the other major riskier are team building formations, narrow orientations of the duty and the unrealistic approach towards achieving the goals of healthcare centers in Australia.  Besides that, lack of team building will suffer high loss for the patents and the both individuals in order to solve the interpersonal skills within the heath care the leaders should listen to the everyone thought and the choose the suitable alternative like use of two way communications process.  

Reference list

Books

Barr, J. & Dowding, L. (2008). Leadership in health care. Los Angeles, CA: Sage Publications.

Bowerman, J. & Lamb-White, J. (2007). Leadership in health services. Bradford, UK: Emerald Group.

Goodwin, N. (2006). Leadership in health care. London: Routledge.

Gray, I. & Field, R. (2010). Effective Leadership, Management and Supervision in Health and Social Care. Exeter: Learning Matters Ltd.

Rigolosi, E. & Rigolosi, E. (2005). Management and leadership in nursing and health care. New York: Springer Pub.

Journals

Graetz, F.,Rimmer,M.,Smith,A., & Lawrence, A. (2011). Managing Organisational Change. 3rd Ed.John Wiley & Sons Australia. 

Edmonstone, J. (2011). Developing leaders and leadership in health care: a case for rebalancing?. Leadership In Health Services, 24(1), 8-18. doi:10.1108/17511871111102490

Gilbert, J. (2005). Interprofessional Education for Collaborative, Patient-Centred Practice. Cjnl, 18(2), 32-38. doi:10.12927/cjnl.2005.17181

Male, T., & Palaiologou, I. (2012). Learning-centred leadership or pedagogical leadership? An alternative approach to leadership in education contexts. International Journal Of Leadership In Education, 15(1), 107-118. doi:10.1080/13603124.2011.617839

Martin, J., Theile, D., Ho, K., & Frazer, I. (2012). Diamantina Health Partners: integrating leadership in research, research translation, education and clinical care. The Medical Journal Of Australia, 196(4), 237-239. doi:10.5694/mja11.11251

Petryshen, P. (2011). Achieving Patient-Centred Care: A Reality Check. Cjnl, 24(3), 22-23.

Snell, A., & Dickson, G. (2011). Optimizing health care employees’ newly learned leadership behaviors. Leadership In Health Services, 24(3), 183-195. 

Websites

As.wiley.com,. (2015). Wiley: Managing Organisational Change 3rd Edition – Fiona Graetz, Malcolm Rimmer, Aaron Smith, et al. Retrieved 16 January 2015, from  https://as.wiley.com/WileyCDA/WileyTitle/productCd-EHEP002209.html

adminpanel.ceda.com.au. (2013). Healthcare: Reform or ration. Retrieved 16 January 2015,   fromhttps://adminpanel.ceda.com.au/FOLDERS/Service/Files/Documents/15366~ healthcarefinal1.pdf

www.commonwealthfund.org,. (2015). INTERNATIONAL PROFILES of Health Care Systems, 2013. Retrieved 16 January 2015, from   https://www.commonwealthfund.org/~/media/files/publications/fund- report/2013/nov/1717_thomson_intl_profiles_hlt_care_sys_2013_v2.pdf