The report covers 4 different leadership articles for understanding the theory of leadership used in clinical practices. The first article addresses how clinical leadership is applicable in improvement of services and perceiving quality initiatives by Health professionals. The second article addresses the significance of clinical leadership in hospitals. The third article addresses opportunities and prospects in education and clinical leadership development for nurses. The fourth article addresses needs of leadership development. The theory and problems identified in these 4 articles are discussed in the report. The relevance of findings analyzed from the articles for development of leadership in nursing practices also discussed in the report. In addition to this, the limitations and recommendations contained in the articles are also analyzed in the report.
According to this article, clinical leader is a person having clinical expertise in an area of practice and uses interpersonal skills for enabling the health professionals in delivering quality care to patients. In other words, a clinical leader is skillful and posses great knowledge of an area of practice who lead his followers by giving them vision and directions and empower them for providing better health care to patients. Clinical leadership is the work of practicing clinicians possessing expertise and holding a position of leadership to suggest and direct the other clinicians for providing better health care (Stanley, Blanchard, Hohol, Hutton, and McDonald, 2017). There are certain attributes that are required in clinical leadership which includes clinical competence, communication excellence, management skills, trustworthy and holds integrity, and visionary.
The effectiveness of clinical leadership is not dependent on the leadership or formal management training as many of the health practitioners do not receive any management or leadership training. Rather the qualities for clinical leaderships are developed through years of experience. Clinical leadership also plays a supporting role in taking opportunities for influencing policies at different levels and making the health professionals versatile and leading them in response to change. There are certain factors which act as a barrier to clinical leadership in health profession. These barriers include industry constraints such as lack of time for clinical leadership as experts are engage in their own practice due to high clinical demand. Likewise, the self constraints in clinical leadership include lack of mentorship, confidence, resources and managerial support. The other constraints include change resistance, isolation, and inability to manage work life balance.
A significant growth is observed in the research which explores clinical leadership and from the perspective of nursing. Clinical leaders in nursing are present in adequate numbers but are rarely seen in the roles of senior management. Leadership in nursing is developed when they act upon their beliefs and values related to care. Apart from this, there are certain competencies which are needed to be applied in nursing for developing leadership. It includes demonstration of personal qualities, team working, management and improvement of services, and setting of directions (Kadu, and Stolee, 2015).
The information pooled in the article in context of clinical leadership from the perspective of health practitioners is very shallow. Therefore, research is needed for developing insights and generating knowledge and information related to the perception and application of clinical leadership (Tandfonline.com, 2018).
The hospitals have diverse environment varying in complexity and size determined in playing their role as a system of health care. In the present scenario, the struggle of health care systems continues with the increasing demand of services and costs escalations. Wide range of health care systems functions are linked to clinical leadership. It is effective in enhancing the performance of the health care in hospitals, timely delivery of care, improving integrity of system and efficiency. Clinical leadership is also considered to be a critical component for improving safety and quality in the health care system. According to an Australian example, the position of Nurse Unit Manager is reviewed and redesigned for supervision of patients and ensure that 70% of the time is spend of clinical duties. The rest of the time could be spent on management and administrative tasks.
Clinical leadership is considered to be an ability of clinical leader in influencing the members to act and be able to perform clinical practice (Bender, 2016). Through clinical leadership, the required motivation and support is provided to peers. Moreover, directions are enacted and a vision of safety delivery of services is implemented in the healthcare. In the hospital sector, demand for the leadership role is becoming more complex as there is a need of different leadership forms. It is suggested in the article that dissatisfaction may be experienced by nurses because of working environment within the hospitals. The poor working environment in the hospitals adversely impacts the clinical care delivery and outcomes for the patients. However, the quality of environment for nursing work is improved through increased empowerment and responsibility, enhanced communication, and improved communication which is patient-centered, clarity, and interdisciplinary collaboration (Arnold and Boggs, 2015).
One of the major concerns is that many of the health professional cannot understand leadership and therefore cannot perform leadership roles as the leadership content lacks in undergraduate courses of healthcare To overcome this deficiency many health service providers are implementing leadership development programs in the. In Australia, hospital medical registrars can avail training programs in teaching hospitals. Moreover, a specific program is developed for NUMs specifically so that their clinical leadership skills can be enhanced through activities of professional development (Dally, Jackson, Mannix, Davidson, and Hutchinson, 2014).
The article explains that clinical leadership is beneficial in improving the care in healthcare systems but it does not explains how patients will be benefitted from it. Therefore, it can be recommended to elaborate the benefit of clinical leadership in context of outcomes for the patients (Dovepress.com, 2018).
Clinical leadership is becoming significant in the healthcare workforce due to many reasons which include chaos, complexity, high change rate, quality and safety issues, and shortage of workforce. It is impossible to exactly picture the future but looking at the present situation of healthcare sector it can be analyzed that there is a crucial need for preparing nurses for handling key roles in the delivery system of health care. The clinical leadership role includes integrated care, working with authority, autonomy, and accountability for coordinating care and management across the healthcare setting and disciplines (Huber, 2017). The process of influencing people for accomplishment of goals is known as leadership. Leadership concepts include communication, influence, goal attainment, group process, and motivation. Therefore, clinical leadership can be defined as the process of improving individual care practices and organizational processes as well as influencing point-of-care innovation.
Nurses hold the responsibilities of safety, quality, and improving the experience of patients. Therefore, clinical leadership can be developed in nursing by using their skills and adding components of skills related to management and leadership in the delivery of care. Development of clinical leadership in nursing will be beneficial in improving communication within the teams for improved safety, increasing coordination for medication administration and prescribing and transcription. The ongoing gaps in care could be easily resolved through energetic actions of nurses based on care coordination, teamwork, and competencies of clinical leadership at the point of care. The challenge in implementing clinical leadership includes the structuring of skills, abilities, and knowledge required so that the nurses can be positioned to perform roles which are required in clinical leadership (Grossman and Valiga, 2016). Interdependency and innovation are the two main concepts which act as an opportunity for the development of clinical leadership, education, and practice.
The article does not show the practices which are ongoing for the clinical leadership development. Therefore, more research is required in the area of ongoing practices (NCBI.com, 2018).
The functions of leadership include communication, achievement of group consensus, setting directions, and maintain cohesion in group for achieving effective performance. Clinical leadership includes midwifery and nursing to empower individuals for engaging in change. It also involves motivating and influencing the peers through inspiration, supervision, and mentorship. Clinical leadership also includes care coordination, ensuring adequacy of resources, management of involvement in patient care, understanding politics, partnerships, and networks, and involvement of self in initiating change, team building, and motivating others. Midwifes and nurses are reported to have higher requirement for leadership development. It is more challenging to develop clinical leadership in the nurses and midwives as they hold the middle position in management, carry multiple as well as conflicting responsibilities, and their roles are not even defined properly (Gauld and Horsburgh, 2015).
In order to support the development of clinical leadership in nurses few approaches can be used such as consideration of development of both leader and leadership as a part of spectrum. Moreover, the development programs shall incorporate experience of learning in the work setting only so that opportunities for participants could be reflected (Nursingtimes. Com, 2018).
Conclusion:
It can be concluded that development of clinical leadership is a combined responsibility. Those who are already in leadership position are required to work together for recognizing the needs and develop programs to achieve it. An agreement of partnership between health services and higher education is required for development of clinical leaders.
References:
Arnold, E.C. and Boggs, K.U. (2015). Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. USA: Elsevier Health Sciences.
Bender, M. (2016). Conceptualizing clinical nurse leader practice: An interpretive synthesis. Journal of Nursing Management, 24(1), E23-E31.
Daly, J., Jackson, D., Mannix, J., Davidson, P.M. and Hutchinson, M. (2014). The importance of clinical leadership in the hospital setting. Journal of Healthcare Leadership, 6, 75-83.
Dovepress (2018). Journals. Retrieved from: https://www.dovepress.com/the-importance-of-clinical-leadership-in-the-hospital-setting-peer-reviewed-fulltext-article-JHL
Gauld, R. and Horsburgh, S. (2015). Healthcare professionals’ perceptions of clinical governance implementation: a qualitative New Zealand study of 3205 open-ended survey comments. BMJ open, 5(1), e006157.
Grossman, S. and Valiga, T.M. (2016). The new leadership challenge: Creating the future of nursing. USA: FA Davis.
Huber, D. (2017). Leadership and Nursing Care Management-E-Book. USA: Elsevier Health Sciences.
Kadu, M.K. and Stolee, P. (2015). Facilitators and barriers of implementing the chronic care model in primary care: a systematic review. BMC family practice, 16(1), 12.
NCBI (2018). pmc. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5740995/
Nursingtimes (2018). Clinical-archieve. Retrieved from: https://www.nursingtimes.net/clinical-archive/leadership/identifying-leadership-development-needs/5041224.article
Tandfonline (2018). Doi. Retrieved from: https://www.tandfonline.com/doi/citedby/10.1080/2331205X.2017.1321193?scroll=top&needAccess=true Stanley, D., Blanchard, D., Hohol, A., Hutton, M. and McDonald, A. (2017). Health professionals’ perceptions of clinical leadership. A pilot study. Cogent Medicine, 4(1), 1321193.
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