Question:
Analyse the approach taken by a Leader in effecting a Sustainable Change in Health Services that led to better Outcomes.
The aim of the assignment is to provide individual critical analysis of the content of group poster that includes reference to the ethical theory of leadership. The poster contains information as per the selected learning outcome and the graduate attributes of the unit that relate to leadership, ethical and moral theories and practices, and implementing change and innovation from a leadership perspective. The objective of the critical analysis is to elaborate on what might have been a better way of implementing the planned change as per the evidence available on change management process. Any ethical implications that may have been considered will be analysed. Further, critical analysis also includes if a change have been implemented perfectly and if good outcomes have been obtained. Further, if good outcomes are obtained then the assignment aligns why was the chosen approach was appropriate and effective. The critical analysis of the poster also comes from the reflective writing on the strategies implemented by the leadership team for planned change as part of the previous assessment. Critical analysis focuses on how the leadership team managed the change situation. The assignment also briefs the peer review feedback on the Padlet walls as a part of the critical analysis. The critical analysis is supported with relevant literature.
Before critically analysing the poster let us have a brief introduction on what it was all about. The poster was the part of the assessment task 2. I had a group of six members and collaborating together we made a poster. The poster was developed by researching an aspect of leadership in healthcare. This poster based on the reflection submitted as a part of the assessment 1. The reflective analysis report in assessment 1 illustrated the situation of organization that implements a planned change under my leadership. Some senior leaders initiated the change by implementing the set of strategies. The reflective analysis mentioned the concept of the ethical leadership in initiating the change and resistance to change.
Use of PCC approach
Based on the reflective report, the poster was developed by my group. As per the poster the, patient centered care (PCC) approach was successful in increasing the satisfaction of people living with dementia. The poster well depicted that the PCC care approach maintained the personhood by paying close attention to the communication and relationship when dealing with the dementia patients in nursing home. It can be said that the leaders has made an effective decision. The argument can be support based on the evidence from Lynch, (2015) which highlighted that the PCC approach is appropriate for practice development. It is the part of the service delivery model. It is considered appropriate for creating the change in the organisation. It is evident from the poster that there was a negative staff response due to implementation of the PCC. The negative response included having an adverse view of dementia. The staff in the nursing home believed that the dementia patients have a challenging behaviours and it is difficult to tackle. It was depicted in the poster that the staff had low motivation to initiate change and the organisational culture lacked innovation and development. Highlighting the negative responses of the staff can be considered a strategic plan to set platform for explaining facilitation of change using various methods (Smith Ali & Soldatov, 2014).
Strategies used in poster
The poster sequentially explains each step of the change management initiated for dementia care. After highlighting the staff behaviour and perceptions, the poster explains the strategies utilised to facilitate the change. All the strategies were found effective in implementing the change process. Starting from the first strategy, which was education, it was a justified to be used in this context. According to Kelly, (2012) staff any organisation requires education to improve the efficiency. Education strategy used in this case was learning programs and collaborating with the staff to determine the right approach for change initiation. This strategy adds to the strength of the poster as collaboration between leaders and the staff is necessary to identify the unique competencies and skills of each staff member. It will assist in meeting any training gaps in the organisations. The next strategy as mentioned in the poster to facilitate the change process was motivation. The senior leaders decided to encourage the staff involvement in the meetings and committees. The next strategy for motivation is to delegate for implying the level of trust and recognition. Twyla Dell writes in An Honest Day’s Work (1988), that giving people what they really want is the heart of motivation. Any organisational goals can be achieved by the meeting the needs and wants of the employees (Mathur, 2013). In this context it can be interpreted that the poser presentation smartly represented the important points of the change management process based on the reflective analysis report. Motivation of nursing staff by encouraging a staff development is an important leadership strategy to help them gain a positive perspective of PCC approach in nursing home. It will help build self esteem and capability (Keyko, 2014).
Leadership style for change management
The third strategy used by the senior leaders for improving the dementia care to the residents in the nursing home is the change of the organisational culture using authentic leadership style. Further, to initiate change in the organisation the senior leaders demonstrated the integrity of the leadership team. The leaders were involved with the staff and encouraged them by building trust and exploring different point of views. These strategies for changing the culture are effective for any organisational change process. These strategies are evidence based and success is sure to happen. According to Leroy et al. (2015) authentic leadership incorporates ethical principle and exhibits high self awareness, focus on long term results, integrity, ethical, lead with heart, lead with vision, effective listening skills, transparency, and consistency. Authentic leaders are effective at leading a change using a win-win strategy. Thus, leadership style is suitable for a situation where the change is needed and in this case it can be considered a sound decision to implement the change process. Overall the leadership style reflects the consideration of the ethical issues.
Despite the evidence on efficacy of authentic leadership, I feel that the senior leaders should have chosen situational leadership model. The rational for this recommendation is the evidence of its efficacy in different challenging situations faced by leader when leading a change. In this model of leadership a leader can use different leadership style depending on the situation. When working with a team different members have different perceptions. Therefore, different member may create different situation (Lynch, 2015). In this model, if the staff members are associates are enthusiastic but lack competence to deliver the duties then leader can implement “Telling/directing” skills which includes supervision of associate without building rapport. When the followers lack willingness and confidence to work, the leader need to push and encourage them using the coaching and two way communication skills. This leadership skill helps staff to gain self esteem as leader takes their ideas and suggestions and involving them in decision-making. When followers are highly committed and confident in achieving the organisational goals, the leader focus more on building relationship with them (McCleskey, 2014). The features of this model align with the transformational leadership, authentic leadership and autocratic leadership. Therefore, it is more advantageous to use situational leadership model encompassing all the leadership styles instead of one leadership style.
Talking about poster, the other strategies for changing the organisational culture that is integrity of team and exploring of different viewpoints of team members by building trust is a successful strategy of ethical leadership. It helps create atmosphere in the team where the staff feels free emotionally and mentally to invest their time and energy into the work (Taylor, 2012). According to Northouse, (2015) trust helps followers to move out of the comfort zone into the zone of the change and uncertainty. Taking the followers view points and involving them in decision is the best method to grow relationships with them. Kouzes & Posner (2017) argued that authentic leaders are effective at developing trust with the followers and are ethical in behaviour. Once again the senior leaders have used evidence based strategy. A rich literature is available on efficacy of these strategies in developing person centered care approach for dementia patients (Rokstad et al., 2015).
It can be judged that the poster has included the positive points in the previous reflective analysis report that focused on transformative, authentic and servant leadership styles. It can be considered that senior leaders are competent in decision-making. It was justified to decide on using the authentic leadership for the nursing home staff. It was recommended at the end of the reflective analysis report that the leadership of the organisation should establish trust and show integrity. The other recommendation that leaders should involve followers in decision making was also considered in the project as the strategy of demonstrating integrity was used for changing organisational culture for dementia care. The recommendation was integrated in the poster presentation. This can be considered the strength of the presentation. All the members in the group did well collaborate to make the poster meaningful and appropriate (Shi et al., 2014).
In addition to the strength there are weaknesses observed. Considering the reflective analysis report our groups was to make the poster presentation. The reflective report emphasised on using the Kottar change model. This model is successful for implementing the change management initiatives. Leaders are to acknowledge the cultural differences will certainly assist organization to overcome from ineffective leadership approach. However, in the poster presentation there was no emphasis on the hygiene motivators and the cultural consideration for different staff members in team. There was no integration of Kottar change model and is considered the drawback of the study.
Outcomes of the change management
The poster next presents the evaluation of the effectiveness of strategies used for implementing the PCC care approach for enhancing the dementia care. As per the staff questionnaires post implementation, there was an increase in the staff knowledge of dementia care, They demonstrated better awareness of the organisational culture. There was change in the staff attitude from pessimistic to optimistic one. The staffs acknowledge the importance humanistic approach and retaining the personhood in dementia care. Response from the survey further revealed that the staff is aware of the implications of PCC approach. It can be interpreted that initially the nursing home staff was resistant to change and after implementing the evidence based leadership strategies the staff is looking forward to dementia care change. Use of the survey is advantageous as it generates quick report on factual information about individuals. It is the low cost method and omits the observer subjectivity. There is a greater precision in terms of data gathering (Creswell, 2013). However, survey method has drawback. The data may not be reliable if the questionnaire was inappropriate. Qualitative interview should also have been used. Interview gives subjective data and it is more appropriate to explore the participant’s perceptions and opinions (Creswell, 2013). It cannot be said that there is 90% compliance on the audit. It is the drawback noticed in the poster presentation. Highlighting the statistical significance would have been more convenient to the readers (Creswell, 2013). However it is an undeniable fact that the leadership strategies have led to positive outcomes in the nursing home. Since positive outcomes have been achieved, it can be said that the leadership style and the strategies of change management are appropriate. The drawback of the poster also comes from lack of information if the change in nursing staff observed, will be sustainable or not. It will be sustainable if the ethical leadership is consistent. There should have been an indication of how the change observed in the nursing staff will be sustained by the senior leaders.
Based on the overall critical analysis, it can be said that the academic poster well presented the summary of the research conducted by my group in a visually engaging way. Our group was successful in presenting the academically sound work highlighting the context of work through related images. Moreover, it comported the ideas from the reflective analysis report which was the main criteria of the assessment 2 submission. Overall the poster indicates that our group well collaborated in researching an aspect of leadership in healthcare to develop a group poster based on my reflective report submitted in assessment 1. It was a good opportunity to critically analyse the poster as it highlighted the loopholes in my own poster. I learnt the team effort and team working skills. It enhanced my researching skills and use of appropriate citations pertaining to the topic.
Feedback received
As per the feedback of my peers in the Padlet walls, they liked the title as it was short and comprehensible for broad audience. As per their feedback there is an appropriate scope and depth of the content. The poster well distilled the work without losing the flow. As per the feedback of my peers the layout the poster guides the eyes of the audience from beginning to end, from one succinct frame to another in logical manner. Our group effort was successful in highlighting the important content in concise manner. Overall the poster has illustrated the relevant concepts of change management using ethical leadership. It well defined the purpose and concise enough to grab reader’s attention. Reading the feedback, it appears that my friends are satisfied with the efforts my group has made in searching and presenting the topic smartly.
References
Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=EbogAQAAQBAJ&oi=fnd&pg=PP1&dq=quantiative+method+and+qualitative+method+&ots=cbaTsTLuF8&sig=DB0nwwwOlGLfFw5MFZHWkmkwtPU#v=onepage&q&f=false
Kelly, P. (Eds.). (2012). Nursing leadership & management (3rd ed.). Clifton Park, NY: Delmar/Cengage. https://books.google.co.in/books?hl=en&lr=&id=UXQJAAAAQBAJ&oi=fnd&pg=PR5&dq=+Nursing+leadership+%26+management+&ots=KhKuB0XPGQ&sig=BLtAQX_-bCf6PHFxkQ82hdfsJ1Y#v=onepage&q=Nursing%20leadership%20%26%20management&f=false
Keyko, K. (2014). Work engagement in nursing practice: A relational ethics perspective. Nursing Ethics, vol. 21(8), pp. 879 – 889. doi/abs/10.1177/0969733014523167
Kouzes, J. M. & Posner, B. Z. (2017). The leadership challenge: How to make extraordinary things happen in organizations (6th ed.). San Francisco: Jossey-Bass. Retrieved from: https://scholarcommons.scu.edu/faculty_books/182/
Leroy, H., Anseel, F., Gardner, W. L., & Sels, L. (2015). Authentic leadership, authentic followership, basic need satisfaction, and work role performance: A cross-level study. Journal of Management, vol. 41(6), pp. 1677-1697. doi/abs/10.1177/0149206312457822
Lynch, B. (2015). Partnering for performance in situational leadership: a person-centred leadership approach. International Practice Development Journal, 5. Retrieved from: https://search.proquest.com/openview/aa67536a3ae70757414546a29623f561/1?pq-origsite=gscholar&cbl=2030535
Mathur, A. (2013). Employee Motivation, Adjustment and Values as Correlates of Organizational Change. Review of HRM, 2, 35. Retrieved from: https://search.proquest.com/openview/15b9484911328cdc9432cba5bf1b8df9/1?pq-origsite=gscholar&cbl=2035688
McCleskey, J. A. (2014). Situational, transformational, and transactional leadership and leadership development. Journal of Business Studies Quarterly, 5(4), 117. Retrieved from: https://search.proquest.com/openview/e03631119c37d022b66d4ea5fe176e3f/1?pq-origsite=gscholar&cbl=1056382
Northouse, P. G. (2015). Leadership: Theory and practice. U.S.: Sage Publications Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=TuyeBgAAQBAJ&oi=fnd&pg=PT18&dq=Leadership:+Theory+and+practice.+U.S.:+Sage+Publications+&ots=myRLrG5N-h&sig=LtXSrZcdEdX7zzLOPBoA56_dp0E#v=onepage&q=Leadership%3A%20Theory%20and%20practice.%20U.S.%3A%20Sage%20Publications&f=false
Rokstad, A. M. M., Vatne, S., Engedal, K., & Selbæk, G. (2015). The role of leadership in the implementation of person?centred care using Dementia Care Mapping: a study in three nursing homes. Journal of nursing management, vol. 23(1), pp. 15-26. doi: 10.1111/jonm.12072
Smith, A., Ali, F., & Soldatov, D. (2014). Poster presentation. Acta Cryst, 70, C921. Retrieved from: https://scripts.iucr.org/cgi-bin/paper?S2053273314090780
Taylor, V. (Ed.). (2012). Leading for health and wellbeing. London: Sage. Retrieved from: https://us.sagepub.com/en-us/nam/leading-for-health-and-wellbeing/book23861
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