Effective leadership in the healthcare profession is a key component to the success of a healthcare network. Diane Devlin, the Director at Wayne Country Public Health Department, is an example of a competent leader. As a nurse leader, she is responsible for developing and maintaining an environment that not only establishes positive patient outcomes but an environment that fosters positivity within each employee. To effectively manage patient care, Diane has developed skills and expertise in many areas, including emotional intelligence, critical thinking, quality improvement, conflict resolution, employee relations, and performance and risk assessment.
Diane Devlin has thirty years of experience in the healthcare field.
After obtaining her BSN, RN, she worked for a hospital for six years and home health care for ten years. The, she transitioned into a coordinator role for a migrant heath care program with Wayne Country Public Health Department (WCPHD). While maintaining this position, she went back to earn her masters degree in leadership in healthcare systems: health promotion, education, and technology at the University of Rochester.
Upon graduation, she became the supervisor for prevention services with WCPHD. She was then was promoted to the director of WCPHD. Dianes typical workday is Monday to Friday from eight to four. However, she does have twenty-four-hour coverage for any serious health issue in Wayne County.
Diane is involved with many organizational committees. She serves as a member on the board of directors for Wayne County Rural Health Network, she is on the Wayne County Improvement Partnership (WIP) board, she attends the Rural health network S2AY meetings, and she is on the Wayne County Coordinating Council (WC3).
Weekly meetings are not held at the WCPHD; however, there are monthly public health staff meetings that she attends. There are twenty-one staff members that work with Diane at WCPHD. Education levels range from a high school education to a masters degree.
The goal of the WCPHD is to promote health and wellbeing for the residences in Wayne County. Some of the services the department provides includes lead poisoning prevention services, immunization clinics, maternal and child health services, and tuberculosis clinics. The department serves roughly six hundred residents per year (Wayne County Public Health Department, 2019). The majority of the residents that WCPHD services include Caucasian individuals, over the age of sixty-five, with a high school education. Most residents of Wayne County are not insured or they have Medicaid and Medicare insurance. As a result of the Affordable Care Act, there has been an increase in the number of Amish and Mennonite patients because this population is not required to obtain health insurance with the Affordable Care Act.
Diane describes herself to be a situational leader. Diane believes that this leadership style best suits her personality. A big part of being an effective leader is to recognize a situation and know how to handle different personalities in each unique situation; there is no one size fits all theory in leadership (Chapman, 2018). Diane is able to use critical thinking skills to adapt her leadership style to each situation. She stated that “some individuals need more direction than others, in this case I need to adapt my leadership to the employee I am attempting to influence or lead at that time (D. Devlin, personal communication, January 30, 2019). She also explained that some of the situations she encounters requires a more authoritative style. An authoritative leader can make a decision quickly while showing strength and direction (Fowler, 2017). For example, when there is a public health emergency, Diane needs to be more authoritative and directive to take control of the situation. In this type of situation, Diane uses an assertive communication style. Diane stated “I am to-the-point and direct” (D. Devlin, personal communication, January 30, 2019). However, Diane is honest and straightforward without devaluing or disrespecting others (Cherry & Jacobs, 2017).
Diane stated that the pros of this leadership style is that it is “geared towards the learning capabilities of others others appreciate the flexibility (D. Devlin, personal communication, January 30, 2019). She explained that if she was always authoritative, the staff would be hesitant to come to her office and talk with her about an issue. Diane stated that a con of this leadership style is that it is easy to get taken advantage of (D. Devlin, personal communication, January 30, 2019). For example, sometimes she finds staff complaining instead of working toward solving a problem.
As a leader, Diane describes herself to have integrity. Integrity is the alignment between a leader’s words and deeds (Kang, 2018). She explained that one of her greatest strengths is that she strives to do the right thing when no one is looking, even if that means she needs to own up to a mistake. Diane also believes that her strength is having emotional intelligence, or her ability to perceive and manage the emotions of self and others. To manage and cope with her own emotions, Diane likes to talk with her friends to vent and destress. On the contrary, Diane said that her greatest weakness is being too hard on herself. She stated I take things to heart and sometimes that leads me to experience burnout (D. Devlin, personal communication, January 30, 2019).
Diane used various public health and healthcare department directors as her mentors. These mentors helped support her success by offering wisdom and advice. The mentors were able help her “think outside the box and help her create unique solutions to problems. The mentors brainstormed with her, connected her with other resources, and offered support when learning to set public health priorities. In question, Diane was able to call, email, or visit her mentors.
Quality initiatives includes measuring performance against a set of predetermined standards; the goal is to determine how to improve the delivery of quality care (Cherry & Jacobs, 2017). To ensure that the patient safety, risk, and quality activities are in line with the strategic goals of the organization there is a risk assessment every quarter. A Performance Measure Quality Improvement Plan (PMQI) is also required. This plan outlines when the WCPHD should do a quality improvement (QI) project. WCPHD uses the Fishbone Diagram as a QI tool. This tool is a cause-and-effect diagram that identifies the issue and possible solutions (Verhoeff, 2018). WCPHD also has a Compliance Program that develops and approves the standards and maintains a written corporate compliance plan.
Audits are used to create beneficial quantitative data. Diane serves as a resource for external and internal compliance audits. Internally, she audits the clinics and programs on a quarterly and annual basis. Externally, she is the unit representative for the health department for the Compliance Committee. In this role, she ensures that the audits are on the agenda for each monthly PMQI meeting. At this point, data is collected, analyzed, and compared with the established benchmark (Henry et al., 2016). Benchmark goals are created by the state to regulate at what level the outcome indicators should be met. If a specific program does not meet the definition or the benchmark, the WCPHD will do an audit and potential solutions are implemented and reevaluated.
When conducting performance appraisals, Diane follows a formal evaluation process based on performance standards. Performance standards outline a model of greatness for work activities; it serves as the foundation of comparison between actual and aspired work performance (Cherry & Jacobs, 2017). On an annual basis, she looks at the performance measures for the programs and for the employees. She then grades the employee on the completion of the measures. Supervisors are required to sit down with staff individually and offer constructive criticism. At this meeting, the employee is also expected to list the accomplishments for the previous year and set goals for the next year.
It is important for leaders to understand budgetary responsibilities. Diane stated that “managers need to remain fiscally viable to make informed decisions and to criticality think” (D. Devlin, personal communication, January 30, 2019). By monitoring the budget frequently, a manager is able to identify if a program is no longer fiscally sound. Diane explained that WCPHD has five internal budgets that make up the overall budget. The Principle Account Clerk creates the budget and the fiscal staff monitors the spending. Every month Diane will perform a variance analysis to see how much WCPHD is over or under budget, she will also analyze how much money is left in each budgetary line (Cherry & Jacobs, 2017).
It is important for leaders to understand human resource: the composition, recruitment, training, mentoring, and retainment of staff. When there is an open position, Diane posts a job opening in the paper and on Facebook. The majority of the hiring is done through internal promotion. In the interview process, Diane strives to look for the right fit by asking behavioral based interview questions and watching body language. Upon hire, new staff are oriented through a standard process by following a formal manual and an orientation process. During ones career at WCPHD, employees are able to participate in training and professional development. Diane also noted that one of the biggest motivations when retaining staff is the county retirement.
Diane believes in addressing personal issues to promote a productive and supportive environment. To handle interpersonal situations, Diane brings employees together for a staff meeting. She stated if employees have buy-in to the resolution, the percentage of times that they will solve a problem on their own is greater vs if they are just told what to do (D. Devlin, personal communication, January 30, 2019). In the event that there is a disciplinary action, the union contract establishes guidelines. Diane, the supervisor, the employee, and the union representative will also have a confidential disciplinary meeting.
Creating a motivating climate is an important task of a leader. Motivation drives a person to act in a certain way (Cherry & Jacobs, 2017). Diane motivates her employees with the “Star Employee Award. The staff votes for a monthly employee that “thinks outside the box” and performs at a top level. Diane stated that another way she creates self-esteem and job satisfaction is I always try to acknowledge employees for achievement and I offer a simple thank you when appropriate (D. Devlin, personal communication, January 30, 2019). This positive encouragement and support from a leader can create a motivating work environment.
Nurse Leader in Todays Healthcare Environment
When asked, what does it mean to be a nurse leader in today’s healthcare environment, Diane responded with, it means being flexible, having dignity, thinking outside the box, practicing what you preach, maintaining safety and quality, and being courageous (D. Devlin, personal communication, January 30, 2019). Diane offered many wonderful comments regarding advice for future nurses. She listed things such as: volunteer for committees, be professionally involved, keep your commitments, be passion about your work, work outside your comfort zone, bring evidence-based ideas to the unit, network to establish interprofessional relationships, accept new challenges, and ask for shadowing opportunities with leaders in healthcare and business.
After my interview with Diane, I researched additional leadership styles and reflected on my personality to determine what style might be a good fit for me. I believe I am a transformational leader; a leader that is focused on building a relationship and motivating employees through a shared mission instead of focusing on my own interests (AANAC, 2019). I believe I have the personality and the ability to communicate my vision and work through difficult decisions and challenges that may arise (Jambawo, 2018). Because this approach fits my personality, I believe I am capable of positively impacting nursing practice and best care practices (Moving Health Care Upstream, 2019).
A transformational leader is able to provide direction and offer support when needed. As a leader, it is very important for me to lead by example, be proactive, inspire new ideas, and keep communication open. Diane taught me that having an open environment in a professional relationship can motivate employees to create their own solutions and encourage out of the box thinking. This approach allows me to instill professional collaboration and challenge peers to be proactive and take ownership for their work. I think this approach shows others that when a problem occurs, my team can work together to create a solution.
Lastly, Diane taught me that feedback from staff and peers is an integral component effective leadership. I struggle in this area because I can be sensitive when receiving constructive criticism. However, I understand the importance of hearing the perspectives of others in order to foster professional development. Diane also taught me the importance of being an assertive communicator, this is something I want to work on. I aspire to gain confidence in my decisions and opinions. As a new leader, I want to believe in myself and acknowledge the value I bring to a team, despite being a novice.
The success of a healthcare network starts with the leaders behind it. Because nurse leaders create the direction and the purpose in the workplace, Diane stressed how important it is for a nurse leader to follow a leadership style that best fits his/her personality. Diane’s situational leadership style allows her to be a successful leader. Nurse leaders, Like Diane, have the responsibility of making sure the staff and the organization is performing at the highest level of excellence. Effective leaders can successfully provide support, develop skills in clinical reasoning, maintain interpersonal communication, manage finances, perform employee appraisals, resolve conflicts, and participate in risk and quality assessment.
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