Role Of Leaders In Improving Patient Care And Safety Performance

Patient Care and Safety

Critical Analysis of the leadership role in developing a performance improvement plan. Identify an area (one specific) health related practice that requires a performance improvement.

Performance improvement defines as a way to improve one’s working to meet the required performance standards of the job or department or organisation. It can be applicable for improving one’s own performance as well as for improving someone else performance. Performance improvement and measurement have developed as an essential part of today’s health care environment (Hrzone, 2018).   It is a method of the improvement of the procedures and continuous study of providing health care services to meet the requirements of patients and others. To describe the role of leaders in improving the performance, the area which is been chosen is ‘Patient care and Patients safety’. This essay is written with a purpose of describing the role of leaders in improving the a performance of staff, who are engaged in the activities related to patients care and safety, for stating different types of leadership style which will help the leaders in improving their subordinates performance, in continuation it includes the various steps which are required to implement the aspects of workplace performance, it specify the impact of workplace culture on leadership, barriers of leadership, the role of facilitators in change process and then marketing strategies involve in performance improvement, importance of benchmarking in performance improvement and strategies to motivate and engage the staff in performance improvement at all levels.               

Patient care and safety is a discipline that emphases more on safety and health care through reduction, prevention, reporting and analysis of medical error that often leads to hostile effects.  Patient safety has occurred as a separate health care discipline which is reinforced by an immature yet developing scientific framework (Ozcan, 2014).   Patient satisfaction is an important measurement of quality care and the patient and family observation of their care.  In current conditions health care has become more effective as well as become more complex with greater use of new treatment, medicines and technologies. Increase in economic pressure on health system leads to encumbered health care environments. 

Leaders who are engage in patient care and safety focuses more on high patient safety and quality care which will create a workplace where safety and care awareness is the norm. Good leadership is an important part which creates a high quality workplace for health professionals and a safe care place for patients and for their family members. A strong leader provides numerous benefits to patients in many ways (Bonney, et.al. 2014).  

Responsibility of Leaders in Patient Care and Safety

Mainly the responsibility of patient care and safety lies with nurses. The nurses are responsible for developing safe and healthy environment in the hospital. To improve the performance of the nursing staff the hospital management should appoint the leader. The leader can be appointed from the existing staff members or leader can be some external person. The term Nurse Leader is been use for the person who is selected as a leader (Nudurupati, Bititci & Chan, 2011).   To provide best medical care and safety most needed thing is improved quality performance within health care system which relies on constant nursing professional development and overall improvement in system performance.  One of the most important sources of managing improved performance is the Clinical nurse leaders

There are many key role perform by the Clinical leader to improve the performance in work environment which are really helpful in providing care and safety to the patients. Nurses are among those staff members who spent lot of time with patients and their family members, so it become their foremost responsibility to provide good amount of services to them. For that the nurse leaders need to observe the behaviour of nurses with patient and their family if they find the behaviour of nurses are not appropriate with them than the leader can talk action  against them or firstly they can worn them in relation to their behaviour (Burrell, 2014).  The nurse leader is an in charge for assigning duties to other nurses for that nurse leader need to plan a proper strategy with the help of which they can assign task according to their abilities which will help in enhancing their performance in the job the leader can adopt the job change strategy also to improve the performance of staff (Melnick, 2011).   Another role of nurse leader is they act as link or connection between hospital management and interdepartmental staff. The main role of nurse leader is they need to think creatively to improve the performance of their followers by developing effective new ideas. The nurse leader can arrange a training and development program for nurses.

There are some leadership styles which is been use by many health organisation such as Sydney Private hospital, these leadership styles can affect change in performance level firstly the leader can adopt transformation leadership style which will help them in building optimistic relationships and motivate individual staff members. Transformational leaders are focused, charismatic and passionate on successful outcomes (Weberg, 2010). Transitional style is widely consider as a standard in nursing leadership because it provide great job satisfaction and promotes improved patients outcome. The various health councils consider transformational leadership as an essential component for patient care and safety (Cummings, 2010).

Leadership Styles in Patient Care and Safety

Next the leaders can use transactional leadership style to motivate employees. The transactional leaders inspire their employees with help of punishment or rewards to get daily task accomplishment (Harms & Crede, 2010). The transactional leaders focus more on getting particular tasks completed by managing each portion. The leader mainly focuses on getting job done without significant change. They believe in either positive or negative, standards, procedures or rules to gain compliance (Clarke, 2013).   

In addition the leader can use Autocratic leadership. Autocratic leadership is proved when the decision made by the leader without considering other inputs. Autocratic leaders use negative reinforcement and punishment to enforce the rules. In Autocratic leadership the leaders blame individuals rather than a defective process (Skakon, Nielsen, Borg & Guzman, 2010).  Well the autocratic leadership style not work in day to day situations, it is helpful in emergencies when there is very less time for discussion or collaboration. Autocratic leadership helps in enforcement of policies and producers, but it does not promote trust or communication (Hoel, et.al. 2010).

One more leadership style is there which a leader can use to safeguard the interest of patients and their family members, Laissez Faire leadership style also popularly known as absence of leadership and encourage the approach of personnel management, which allow the staff who are engage in the patient care and safety to work without direct guidance and supervision (Furtner, Baldegger & Rauthmann, 2013). But the application of this leadership style can be injurious for the working conditions of the hospital as it leads to the culture of blame. However the laissez-faire also has shown up as an effective leadership tool when the working members are highly skilled and motivated (Malloy & Penprase, 2010).  

Another leadership style can be chosen for enhancing the care and safety of patients, democratic leadership style which encourage the staff nurses to contributes and communicate openly in decision making. The leaders who follow democratic leadership style, focus more on building relationships with the motive of staff development and job satisfaction (Hoel, et.al. 2010).  And their main aim is to improve system and processes, rather than blaming individual members for mistake. However the decision making process is slow down due to increased participation of all team members (Ojokuku, Odetayo & Sajuyigbe, 2012).  

To implement the performance improvement plan in workplace the leaders need to follow few steps which will help them in improving the working conditions by motivating staff members to improve their performance level. Before start with the improvement plan the leaders first need to make sure that they are fully aware of all issues which may be behind of poor performance of the employees. And the reason behind the struggles the employees are facing, that can be lack of proper training or work pressure or other reason. Sometimes personal and family issues are getting in the way of employees ability to tackle these kind of situation the leader need to be very humbly (Phillips, 2012).  It is important for the leader to go to the depth of the problem which includes uncover or hidden issues. In the next step the leader will involve the employees in drafting an improvement plan. The employees are very keen to take part in the planning of performance improvement plan because this gives them an opportunity to add their perspective and drop their ideas in the plan, about what they need to change to improve their performance (Juan, Gao & Wang, 2014).But the right only lies with the leaders and management to accept employee’s idea or not, if they find the suggestion provided by the employees relevant and then only they will accept it otherwise they will plan the process as per their discrete.

Steps to Implement Performance Improvement Plan in Workplace

In next step the leader will set clear objectives which are at the heart of performance improvement plan. The employees need to be crystal clear about what the leader want from them and how they will measure or review the performance standards. The leaders need to make sure that the designed objectives or targets are realistic and can be performed with in a time frame (Rummler & Brache, 2012). In continuation of the process the leader will arrange a proper training and development program and in addition they will provide their full support to the staff members because the lacks of appropriate skills are the root of poor performance.Training and development should be an integral part of performance improvement plan. Before implementing training and development program the leader need to identify the gaps between existing and desired skills and knowledge. The proper training and development program are really helpful in developing work understanding and capacity (Goetsch & Davis, 2014).  After providing proper training and development the leader will set regular dates to review and document the progress. This will give a target to the employees to work towards the opportunities given to them and to make sure that what actually they are doing is on track or not. Having a clear goals and plan of action will result in improvement in performance (Weaver, et.al. 2010).

The working culture provides its influence on patient care and patient safety. The Care quality mainly depends on two factors these are, effectiveness of care and access to care. Accessibility of health care defines that patients can really getting the amount of care they need during clinical effectiveness, the care received results in the projected outcome. Both the concepts are prejudiced by the structure and procedures in the health care system. Access can be limited by both affordability and physical location. Effectiveness comprises evidence or guideline concordant care, knowledge based care, or clinical effectiveness and is repeatedly measured as compliance of the provider to the evidence or guidelines (Chen & Li, 2010).  

Safety of Patient can be broadly associated to the diagnosis errors, treatment errors, and possibly absent precautionary services, since there is some overlap in diagnostic and treatment errors with quality of care, which includes performance to deal with absent self-justifying services or other metrics that represent management of disease or appropriate care with the quality measures. Medication errors may be the result of structure within the non-clinical or clinical process and health care system (Aiken, et. al. 2011). Satisfaction of patient often includes components of quality of patient safety and patient care and as patients tends to be more satisfied if they are getting high quality of care and they are not subject to medical error. Mainly patient satisfaction categorize as static faction provide by the provider and satisfaction with the clinic. Satisfaction can be calculate by using different scales and may be prejudiced by process of clinical care as by the clinic environment or structures.  

There are many barrier involve in the performance improvement these are resistance to change, this the most prevalent and most common barrier for performance enhancement, the human nature is resist against change as the change in work or work condition demand lots of new and extra efforts and people are always want to stay in their comfort zone so it become difficult to overcome this barrier. Another barrier is absence of commitment to performance enhancement from employees or leader. Many administrators, physicians, managers, and other staff interpret that performance enhancement not as a essential task they just consider it as an agreement (Cooke, 2010). Need of professional independence such as peer review and physician’s history of self-governance can be treated as a barrier. Health organisation has inadequate resources and many view performance enhancement as an activity which involve cost and does not add value to organisation. In culture of health care system the shame and blame culture and fear associated with the undesirable performance and medical errors.  Critical issue among professional and department are common problem in the health care system. Time restrictions are often quoted as a cause for not being able to participate in performance enhancement activates. The team associates and other comes to the particular project with their personal agenda and work to achieve their personal goals that mainly are not in interest of the particular project. The performance enhancement process is too complex and unwieldy. Facilitation is the procedure which offers support to individuals or group of individuals to attain the valuable changes. It also describes as the provision of resources encouragement, opportunities and support for the group to succeed in achieving its own objectives. This process is in the health care system to enable the groups to take control and responsibilities. A facilitator can be define as a catalyst for change or as a person who helps others and give direction by drawing upon their own experience. The facilitators tools consist of primarily skill, knowledge, skills and techniques for structuring and driving a process of change and infrequently expertise in the clinical area addressed by the interference (National academies press, 2017). 

To improve the working conditions and facilitate the proper care and to provide safe environment to the patients and their family members the leaders in Sydney private hospital apply certain management strategies, Firstly the clinical nurse leader of Sydney private hospital focus on the working of team and their current performance, for this the leader need to go through the previous records of the team member. With the help of the previous records the leader will come to know about the particular area in which a particular staff member is lacking or will help in find out the gap between in their current performance and desired performance, then in second step the leader will review their performance and find out the various ways to bridge the gaps between the current performance and desired performance. When the leader will come to know about the reason for decline in performance leader need to design or create and new performance strategy which will bring the change in the Hospital. The performance strategy which the leader going to design needs to be very effective that could help in solving the issues of performance improvement (Melnick, 2011).  When leader is ready with the effective performance strategy leader will let their team member know about the planned strategy with the help of which the leader will be facilitates to perform their role efficiently. With the help of planned strategy the leaders can motivate their team member by introducing various methods of performance improvement.

Benchmarking is a measurement plus comparison of a health organisation facility against other national health care organisations. It offers leaders vision that helps to understand how their health organisation is better than the similar health organisation that provides the similar services. Benchmarking permits the sharing of finest practice and research outcomes and evidence based practice between health care facilities like patient care and safety at a national level. Benchmarking in health organisation can be custom-made to precise areas of nursing such as hospice, long term care hospitals and home health facilities. The four central principle of clinical practice benchmarking is improving patient safety, maintaining quality, improving customer satisfaction and continues improvement (Cooke, 2010). A common national benchmarking will ensure all patients who enter the hospital that hospital has full facilities which is required by the patient for its treatment and consist the proper care and safe environment. For benchmarking to be successful the administration should support the goal and the intervention essential to achieve it. Calculating compliance is also paly dynamic role in successful implementation of the benchmarking plan. Patient care and safety benchmarking wants staff associates to systematically audit their clinical practice to ensure that the organisation is attaining the required quantifiable outcomes. Nurses from administration play a dynamic role in ensuring that their healthcare facility is a leader in meeting national benchmark standards.

Strategies which are used for improving employees motivation are, firstly the leader need to identify what motivates employees. The human are different from each other in same ways their ways to getting motivate is also different, so all the employees in the healthcare system will not responsive to the same motivators. The employees motivation is tricky just like people everywhere each individual is unique. The simplest way to identify the best way of motivating employees is the leader should ask employees what would make them more excited about their job. Another strategy will be the leader or manager should take genuine interest in employees care path, employees attitude can change positively if they believe that the manager or leader cares about their future and job. Leader can provide them training and opportunities for their careers advancement. Most of the employees are getting motivated by money, some use their salary to measure their value to the work (Healthfeild, 2017). Compensate and give rewards is a good measure of motivating employees. Financial rewards can be in method of performance bonus, raises, commission, and profit sharing. Extra items could be used as compensation can be uses of motivation are gift vouchers or other non-monetary gifts. Sometimes creating new experience for the employees could help leaders to motivate them and also in improving the productivity. The various ways to create new experience in job includes job rotation, job enrichment and job enlargement. All the above stated strategies can be used by the manager or leader of the hospital to motivate their staff members, to increase their work quality and help them in engaging the stakeholders and staff members to improve their performance and enhance the quality of patient care and safety.

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